Duke Kahanamoku knew. Kelly Slater knows. And some young Hawaiian surfer would like to know…how to ride big waves.

Phlebology has had three big waves. Maybe not as exciting as Big Wave Riding in Hawaii, but the Phlebology waves are exciting to an older surfer such as myself who enjoys catching a three-foot wave on a long board on a beach out on the eastern end of Long Island. It might be better and safer to choose to ride the Phlebology wave than any surf wave at this point!

It’s been more than 10 years since endothermal ablation became available to the masses. Whether in the form of laser or radiofrequency, these techniques brought us into the 21st Century and transformed the management of venous disease. There have been variations on the theme and other minimally invasive techniques have evolved to manage axial veins, branch veins, suprainguinal veins and small subcuticular veins.

Societies that had existed prior to 2000 have also matured, responding to the changing needs and significantly growing with new members. Societies are more focused and better organized. There is much more intersocietal collaboration and cooperation.

Industry has been another driving force. Of course industry wants to sell products just as we as phlebologists want to sell our product, but an era of cooperation has evolved. This cooperation has led to stronger venous societal strength. For example, industry is a part of the ACP Foundation and AVF Foundation. Their support has been generous and extremely beneficial.

The Phlebology Waves

Most of us who were around during these developments are still actively participating. We are still taking care of patients; we are still involved with our societal commitments. But we are not going to be doing this forever.

This is the basis for what I call “Waves of Education.” The First Wave was the education and growth of the early adapters – those who embraced the minimally invasive management of venous disease early in this century (2000-2004). These individuals are our current thought leaders and educators, and they prepared us for the next wave.

The Second Wave (2005- 2010) has primarily been the education and growth of already-practicing physicians who wanted to treat venous disease in a modern, minimally-invasive manner. The surge of physicians adding phlebology to their knowledge base has only served to build momentum.

Now, the Third Wave has arrived and it is our responsibility not only to help shape their education, but to ride it through with them. The Third Wave is the Next Generation of vein specialists. They will come from recent graduates or current trainees. They are our future. And they, in turn, should be the leaders in the next wave, setting the standard for each wave to come.

We have already started teaching this group how to ride our waves. Programs such as The AVF Fellows Course in Venous Disease, The Attending Course in Venous Disease and The Preceptorship Program of ACP have been quite successful over the recent years. ACP, AVF and SIR all have support for their meetings so that young trainees, including medical students in some cases, can attend the annual meetings at reduced cost. Much of this is possible through industry support.

Embrace and educate the Third Wave

We at VEIN Magazine are well aware of the need to educate and excite not only this Third Wave, but all of us that are currently involved in managing venous disease. VEIN will continue adding features that address the needs of current and future phlebologists, and VEIN plans on being the resource for the identification and education of the Third Wave.

Our mission is to be a forum where the triumvirate of vein societies, vein industry and vein practitioners can voice ideas and educate the next great surfers of phlebology.