by Gordon Gibbs, MD Founder and CEO, Rocky Mountain Vein Institute
Venous disease is an extremely common medical problem that is easily diagnosed and readily treated with contemporary technology. Good clinical outcomes are expected. When you take a common problem and apply a good solution, demand for your services tends to increase.
At Rocky Mountain Vein Institute (RMVI), we took this scenario and anticipated a problem: Sooner or later, I (alone) would no longer be able to accommodate the volume-of patients seeking care at our single private practice vein clinic. One of our solutions to this ?problem? was to create a fellowship pathway to recruit and train new phlebologists within our practice.
Prior to launching the RMVI Fellowship, our options for recruiting and hiring a new phlebologist included finding a previously trained new graduate, hiring a previously trained phlebologist already in practice, or hiring a physician and training him or her to become a phlebologist. Each option has advantages and disadvantages.
When hiring a new graduate, we encountered smart, ambitious physicians who generally wanted a broader scope of practice than just vein care, but we needed practitioners who focus entirely on vein care. When interviewing previously trained phlebologists coming from another practice, we discovered their style of patient care and personality might not mesh with our own. That said, hiring a previously trained physician meant we could immediately place that doctor into the patient schedule to become a productive, revenue- producing member of the team.
At RMVI and Trinity Vein Institute (TVI), patient care, patient satisfaction and optimal outcomes are paramount concerns. The patient always comes first. From the first phone call to the final follow-up visit, we want our patients to feel valued and know that we cater to their needs. We have a team environment where everyone answers the phone, takes out the trash, cleans up the break room and, of course, participates in premier patient care.
Accommodating this culture takes a unique physician personality, one that may not readily be found in physicians with a long established style, engrained habits and tendencies. With that in mind, it became clear that we should create our own training pathway to build and shape the team we wanted and to ensure everyone was comprehensively and properly trained.
Our RMVI Phlebology Fellowship includes didactic studies, observation, handson training, and, immensely important, immersion into a practice culture that is based on customer service. We call it ?The RMVI Way.? Our goal is to train our fellows to become board-certified phlebologists who are specialized in our way of care so they can be contributing members of a team who will grow with the company and eventually become productive, well-trained caregivers and leaders.
For the practical academic and didactic training, we lean heavily on the excellent work of physicians from the American College of Phlebology who have previously outlined a core curriculum to be taught and learned in a 12-month, ACP-accredited fellowship.1 Our new fellows are given access to study materials, online lecture series, books from our library, and phlebology boards review course. New fellows are introduced to patients as trainees, and their presence and participation gradually increases commensurate with their knowledge base and competency.
Fellows learn office operations and flow, computer and phone systems. They become familiar with the variety of ultrasound studies offered in our diagnostic center, and they are gradually introduced to procedures, starting with observation, then cosmetic sclerotherapy to volunteer patients, ultrasound-guided venous access, assisting during ablations and phlebectomies and, finally, solo procedures. Other ABPh diplomats in the practice and I provide supervision. All fellows are encouraged to pass the American Board of Phlebology exam once they meet exam prerequisites and eventually will become training physicians to new fellows.
better we train and teach our staff, the better teachers they become for our future staff. To more formally comply with the core curriculum, we recently appointed a fellowship administrative director to oversee the process from start to finish, to track procedures and educational milestones, and to assist with job placement and integration.
Why would an aspiring phlebologist want to join our team? Because of the team we?ve created and the extensive and thorough training our fellows can expect. Our style of care and training is very much based on my training at Mayo Clinic, where I completed a diagnostic radiology residency and vascular interventional fellowship. I hold board certification in both interventional radiology and phlebology, and I hold medical licenses in Minnesota, Colorado and Texas.
Moreover, I continue my work as Medical Director of Diagnostic and Interventional Radiology at St. Mary- Corwin Medical Center in Pueblo, CO, keeping me in touch with community health and a health care system under constant change. I?m still on the front lines myself, both in phlebology and in the hospital. I serve on the faculty for Covidien Vascular and I am a principal investigator with Vascular Insights. I am a speaker, educator and mentor. I love what I do and our staff is right there with me. Best Vein Care, an independent organization which evaluates vein centers, has given RMVI its highest ranking of ?Premier Center of Excellence.?
We have discovered that training in a busy clinic benefits trainees (and staff) because repetition creates muscle memory, creates habit and leads to more rapid procedural competency. It also helps fellows recognize the wide variety of clinical presentations vein patients tend to have. Our staff recognizes their part to play in teaching and training, and everyone celebrates as our fellows progress.
The RMVI Fellowship has helped our clinics thrive and offers hard-earned recognition by our staff phlebologists. Over the years, we have grown from a single site clinic to multiple clinics in two states. Each new provider brings
established professional relationships that are great educational opportunities to create new referring practices.
There also becomes an economy of scale, where each new phlebologist is able to participate in community outreach and educational events for local physicians or direct marketing to patients. And because each physician was taught in a similar way, they generally communicate in the same way to physicians and formulate treatment plans for patients in a similar way, as well. As a team, we share presentation materials, interesting cases, and complications.
Our fellows come from a multidisciplinary background, and combining the professional history of each specialist creates a synergy that allows our collective experience to grow more rapidly than if practicing alone. It has created unity and has strengthened the culture within our company. Importantly, nonphysician staff know what to expect?and in turn, patients know what to expect and enjoy their care.
RMVI and TVI is a world-class network of medical facilities with a multidisciplinary team of professionals on the forefront of technology. Featuring minimally invasive vein disease treatments, RMVI and TVI house state-of-the-art, full-service and IAC-accredited vascular diagnostic labs. Both the RMVI and TVI teams are comprised of expertly trained and board certified staff, including a medical concierge specialist dedicated to patient satisfaction. Facilities include the latest in electronic medical record keeping, immediate reports to referring physicians, a teaching site with a sought after fellowship and modern, soothing designs in every location. Rocky Mountain Vein Institute has locations in Pueblo, Parker, Canon City, and Vail, CO.
