Lately, it seems that there are a lot of physicians offering vein care as a part of their overall practice, including family practitioners, gynecologists, dermatologists, plastic surgeons and general surgeons. All of them may declare that they are “vein specialists” or trained phlebologists. They may have attended one or two annual meetings per year and have been to weekend training courses.
They may see patients with vein disease as a small part of their larger medical or surgical practice. These physicians are also joined by “laser clinics” promising quick fixes and enticing teaser rates coupled with attractive “stock” before and after pictures to lure you in. They are not physician-run practices, but rather cash businesses that want to mislead you into thinking that many vein procedures are not covered by insurance. So how do you know you are getting the best advice and the most up-to-date treatments available? Here are some basic guidelines.
Choose the right vein treatment center
Is the vein clinic or center where the physician practices focused exclusively on vein treatment, or are there many different types of patients being seen at the facility throughout the day? Do the facilities look clean and professional? Vein specialists generally do all their diagnostic work and perform all of their procedures right in their vein clinics, so the appearance of the office can tell you a lot about the practice. Ask if there are RVT ultrasound technicians on site. These RVT techs are the most credentialed to perform ultrasound-guided diagnostics as part of the evaluation process.
Choose the right physician for your needs
Are you satisfied with the vein doctor’s credentials? Is he/she board-certified in not only general surgery, but more specifically in vascular surgery and phlebology as well? Additionally, he/she should hold either the RPVI or RVT designation that shows they are qualified to interpret ultrasound exams which represent the single most important tool in diagnosing venous disease. While many doctors may claim to be experts, only a qualified vein specialist has the deep and broad knowledge of the venous system that qualifies them to make accurate an diagnosis of your varicose veins.
A qualified vein specialist has the experience, expertise and the necessary equipment to treat your varicose veins. They will tailor the right procedures to your specific problem during consultation. Many part-time phlebologists offer only one to two modalities of therapy.
Most importantly, are you comfortable talking to the vein doctor? Does he/she seem knowledgeable and able to answer any questions that you may have? You don’t want to be in a position of having this important work done to your body without feeling comfortable that you can ask as many questions as you like — and be completely satisfied with the answers you receive.
Make sure the physician adheres to industry standards
You’ll want to be sure that any vein specialist you see offers all the latest and most up-to-date treatments available for vein conditions, and that he or she has successfully treated many patients before you.
Does the clinic offer EVLT, VNUS Closure, Vein Gogh and/or Veinwave technology? These procedures all use vein ablation, a minimally invasive procedure where physicians use either a thin laser fiber or catheter that emits heat to effectively occlude (close off) problematic veins.
Are they comfortable using a combination of ultrasound guided sclerotherapy and VeinLite sclerotherapy with FDA-approved medications such as Asclera and Sotradecol?
If clinics do not at least offer all of these options, you are probably not at a comprehensive vein care center. Beware, most physicians can pick up a syringe of saline and inject your veins as sclerotherapy but this is a far cry from comprehensive treatment that could lead to disappointing results.
Medical society affiliations
All vein specialists should be affiliated with The American College of Phlebology, The American Venous Forum and be a Fellow of The American College of Surgeons. These memberships show a dedication to the field of surgery and phlebology that all patients should expect of their provider.
By Dr. Mark Schwartz
Reviewed February 8, 2017