Bringing vein Care to Rural California / Dr. Stephen Hopkins
by Andrea B. Epstein
Sonora, California. It’s located in central California, in the foothills of the
Sierra Nevada Mountains with a population of fewer than 4,500 residents. The
closest city, Modesto, is about 50 miles and an hour and 20 minute drive, while
Sacramento is more than 95 miles away. Here in the heart of California’s “Gold
Country,” Dr. Stephen Hopkins has been developing a successful vein practice
offering cutting-edge technology to his patients.
A Board certified general surgeon, Dr. Hopkins has been
practicing general surgery since 1995, and practicing in Sonora
since 2000. As a solo practitioner in a small town, Dr. Hopkins
has been a “jack of all surgical trades” – handling everything
from gall bladder procedures to colonoscopies (for which he
estimates doing more than 600-700 per year).
vein Magazine caught up with Dr. Hopkins to learn more
about his emerging vein practice, Sonora vein Center, to
learn why he expanded his practice and to glean some tips
on how to successfully grow and diversify a practice and
patient base in a rural community.
When & why did you open Sonora Vein Center?
Before i opened my center in 2008, there were no
options in Sonora for patients who wanted treatment for
vein conditions. nobody even wanted to offer it in our
community. A decade ago, i offered vein stripping and did
find vein care attractive, but never pursued it at the time.
Basically, i was referring out all patients who could benefit
from radio frequency ablation procedures. Back then, the
nearest vein practice was in Modesto, about an hour and 20
i had another motivating force as well. Frankly, our area
hospital brought in a gastroenenterologist, and i could see
some of my Gi procedure volume starting to slip. This
definitely motivated me to look at ways to expand my
practice and for me, vein care was an obvious choice.
Is your vein practice a large part of your overall
practice? Can you give us a sense of how many
vein patients you see/treat on a weekly basis?
Before i purchased the endovenous radiofrequencny ablation
technology and began offering these procedures in 2008, my
practice was close to 50% endoscopy and 50% general surgery.
Today, about 50% of my practice is vein care, and i probably
have anywhere from 7-1? new vein patients per week. About
half require radiofrequency ablation, and the other half needs
sclerotherapy or veinwave for tiny spider veins.
What treatments/technologies do you offer
in your vein practice?
when i made the decision to open Sonora vein Center,
i wanted to offer the whole spectrum of vein care to this
community. For me, that meant offering a radiofrequency
ablation procedure and sclerotherapy. i have also added in
the veinwave technology for treating tiny spider veins, and
now believe i can provide treatment to any patients in my
area who need some type of treatment for their veins.
To do this, i had to make to a capital investment. First,
in the vnUS Closure device as well as purchasing upgraded
ultrasound equipment that included a vascular package. My
wife is an Rn and was trained to administer sclerotherapy.
As of July of this year, i also purchased the veinwave
technology and my wife & i have both been trained on its use
and application for treatment of small spider veins. Recently,
with my vein practice getting busier and busier, i have
decided to add some staff, and currently am bringing in a
physician assistant as well.
You mention that you’ve added Veinwave to
your service offerings for the treatment of
spider veins. My understanding is that this
technology was only recently FDA approved
(June 2009) and didn’t officially launch the
product until November. How did you find
Veinwave so early on in their U.S. introduction?
My wife, an Rn, was introduced first to veinwave at a
weekend course in Chicago where she was taking a hands-
on training course in sclerotherapy. Here, the equipment
was being demonstrated by a company representative. His
demonstration was very impressive: for small spider veins
treated with the technology, the results were immediate –and
no bleeding or significant side effects were present. My wife
became so enthusiastic after watching these presentations
– she called me to look into buying the equipment and was
a major influencer in my purchase decision.
Your practice has clearly been an “early
adopter” of Veinwave. With a relatively
new vein center, what made you be
one of the first to jump on board?
when i made the decision to move forward with a vein
practice, i knew that my success was more about having
great results than just owning the latest technology. The
results were impressive, but i wanted to get properly trained
and found little opportunity here in the U.S. i decided
that to give my patients great results i wanted the best
training: i talked to the company, and then decided to spend
time with the developer of veinwave, Dr. Brian newman in
What has been your experience with
Veinwave in terms of patient results?
Are there any side effects?
veinwave is great for tiny spider veins. A rule of thumb
for treating small veins is that if you can get the bevel of
a needle into the vein – you should.—and for these veins,
sclerotherapy is the more appropriate treatment. if you can’t for tiny veins that are usually less than 3mm, veinwave is
a great tool. From my experience, no other treatment does
what veinwave does for these small, bright red veins for the
face and legs. Tiny little facial veins just disappear. The wow
factor is undeniable.
As for any after effects – there can be a little redness
on legs afterwards that can last for a few hours. Also,
there is the potential for what are called microcrusts on
the legs, which are tiny scabs where the vein was treated.
interestingly, none of these after effects occur on the
face, where there is no inflammation and the results are
immediate. it’s very effective – no burns or scarring at all.
From my perspective, this is the new gold standard for
treating spider veins. while i admit that i have no experience
with transcutaneous lasers for treating these veins, i’ve
read the literature and the results are inconsistent. with
veinwave, you treat the veins and the veins close. it’s non-
invasive, using thermocoagulation to achieve these results.
Basically, there is no down time for the patients, and no
need for stockings. This is what patients want: to have their
veins treated, walk out and be done.
You have built a substantial vein practice
in an area that is relatively rural. Are there
any additional insights you’d like to offer
VEIN readers regarding the key strategies
that have helped you grow your practice?
The key to successfully using any new treatment and getting
referrals is GeTTinG GReAT ReSULTS for the patients. To
accomplish that, i have focused on a couple of things:
• Don’t try to limit the services you provide. I’m in
a rural area and that’s always been a key to my
practice success – and also why I have chosen
to practice in this type of community. I like
being able to offer a wide range of services.
• Make sure you get trained on any new equipment
or technology you purchase so that you get
excellent results. We get about half of our referrals
from other patients. That type of referral only
comes from providing excellent results.*
• Assure a nice aesthetic in the office
• Hire and retain excellent employees. This is
another key to my practice. I have very low
turnover. That means that patients know
the staff and are comfortable with coming
back to my office time and again.
• For outside marketing, I’ve found that “Lunch &
Learns” work the best here. I update area physicians
regarding vein disease and the various treatment
options. I’ve found this to be the most durable
source of physician referrals over the year.
In closing, can you share with us your vision
for Sonora Vein Center five years from
now – in terms of patient base, services
offered, and your practice overall?
i know that if i want to treat more patients with venous
disease, i’m going to have to do less of something else. i do
want to keep my practice in both areas – general surgery
and veins but probably increase the proportion of vein care.
i definitely don’t want to give up general surgery, which is
why i’m now recruiting for more staff. in five years, maybe i
also will bring on a physician partner.
Clearly, Dr. Hopkins is focused on growing his vein
practice and has taken a classic marketing approach to
finding a niche, or unique need, in his rural community
and then systematically meeting that need by offering a full
spectrum of vein care services. Likewise, his single-minded
focus on providing great results should continue to help build
word-of-mouth referrals for his practice. He’s also building
broader visibility beyond his rural Sonora community, with
a television appearance on Good Day Sacramento in late
December where he successfully treated a patient’s facial
veins with veinwave. with this type of regional publicity, his
vein center is assuredly on a path for continued growth.