I am trying to decide between a vascular surgeon within my insurance group who has done about 100-200 endovenous laser treatments versus paying cash for a well-known vein specialist who has done this thousands of times.
Thank you for your thought-provoking question. Unfortunately, there is no magic number. Why? Each physician's skill set is different. Use your best judgment, when reviewing offices and physicians. Quantity is not necessarily quality.
Published on Jul 11, 2012
This is not an easy question to answer. The well-known specialist clearly has the experience of seeing and treating all the variations in venous disease that occur. If your situation is relatively straightforward, it shouldn't be a problem for the doctor with less experience. This Dr. has done 100+ procedures, so it's not like you are the first patient.
Published on Jul 11, 2012
There is no specific number of cases that determine proficiency. Interventional Radiologists are trained in minimally invasive procedures and are proficient in ultrasound.
Published on Jul 11, 2012
For a straightforward case, 100 cases of experience should be plenty for a good physician to be proficient at endovenous laser treatments.
Published on Jul 11, 2012
Go with the doctor you trust. Many times, a high volume of procedures can mean doing too many unnecessary procedures.
Published on Jul 11, 2012
I would first like to know if the "vein specialist" is a surgeon. We always recommend that patients choose an experienced surgeon to do any of these procedures. They have the background to deal with anything out of the ordinary. However, you also have to be comfortable with whom you choose. A vascular surgeon has done many different types of cases that are likely much more complicated than endovenous ablation and are very familiar with the venous and arterial systems. Perhaps you could ask to speak with some of his/her patients about their experiences. There is a big difference between 100 and 200 cases, but it is still a good number of cases to be proficient.
Published on Jul 11, 2012
The more important issues when choosing your physician are the quality of clinical evaluation, quality of the ultrasound evaluation, judgement of the physician, and skills with other techniques that may be needed for treating residual or other abnormal veins.
Published on Jul 11, 2012
That is a difficult question to answer without knowing both physicians. I certainly would not make the decision solely on the physicians' credentials of vascular surgeon vs. radiologist vs... I trained with many different types of physicians. One vascular surgeon I trained with was excellent, another was horrible. In this case I think reputation speaks volumes.
Published on Jul 11, 2012
Inquire about his monthly volume and ask to see his results. Also ask around
regarding patient satisfaction. I think 100-200 cases should be adequate experience. A
busy vein specialist will perform 50-100 vein closures per month.
Published on Jul 11, 2012
The answer depends on your vein anatomy and the skills of each physician.Generally speaking, you will be better off with the more experienced physician, as sometimes the procedure is unpredictable and the
experience can really pay off if something out of the ordinary needs to be addressed.
Published on Jul 11, 2012
Endovenous Laser treatments are relatively simple and after even a few procedures, a good physician would be fairly proficient. The laser does most of the work. The physician just places the fiber, creates a tumescent protection around the vein, turns on the laser, then pulls the fiber out slowly to burn the vein.
Published on Jul 11, 2012
There is definitely something to be said for experience. However, once you get to 100-plus procedures in regards to the Endovenous Laser Ablation procedure, you are plenty proficient, especially considering all of the other procedural experience the vascular surgeon already has. That being said, what you really need to ask is what other treatments the two physicians are planning for you to help treat the remainder of the abnormal veins in your legs that can not be treated with the Endovenous laser ablation procedure. If they are not planning on doing anything, then I would tell you to go seek a second opinion from another doctor who will. Rarely does a patient have a laser-able vessel and nothing else that needs to be addressed. Do you have spider veins or reticular veins, or even non-saphenous veins that are abnormal? Those veins can make up more than 90 percent of the problem. So, if you are looking for a comprehensive treatment, look for a vein specialist who will address all aspects of your leg veins and not just treat your saphenous vein and then call it a day. They are not doing you any favors.
Published on Jul 11, 2012
The more endovenous procedures that a physician does, the more proficient he or she should become in that procedure. From experience I can tell you that I am much better now having done thousands of them than at the 200 mark. However, 200 procedures should be enough to make one proficient. Another factor to consider is the background of the person doing it. Someone whose entire practice is veins may be more aware of all the nuances versus someone who wears many hats.
Published on Jul 11, 2012