VEIN’s Medical Advisor Helane Fronek, MD, continues her special assignment to highlight Women in Phlebology with her in-depth article illustrating Dr. Joann Lohr’s extensive experience in the venous arena.
Joann Lohr, MD, FACS, RVT, first developed an interest in venous disorders when she came to Cincinnati to work with Dr. John J. Cranley, Sr., who focused on patients with chronic wounds and venous insufficiency and was quite excited by the new onset of duplex imaging. Dr. Lohr recalls his observation that, “For every one patient with carotid stenosis, there would be 20 with varicose veins and swollen limbs. We could help in the effort to reach more people and improve quality of life; that the ‘less glamorous’ venous world was where it was at.” Dr. Cranley felt that a career focused on venous disorders afforded a more predictable lifestyle that might also be appreciated by a female surgeon. While these benefits have been born out, what Dr. Lohr has most appreciated is the opportunity to make an enormous difference in the lives of her patients.
Once she began seeing patients with varicose veins and venous ulcers, it became clear to her that caring for this group of patients was extremely satisfying. Since they experienced the biggest changes in lifestyle after treatment, they were some of the most grateful patients. She recalls patients who would literally jump up and down in the office after their treatment since their legs “felt lighter.” Frequently, this improvement would lead to even greater lifestyle changes. In particular, Dr. Lohr recalls a young nurse she treated early in her career who went on to lose 200 pounds after her venous therapies because she could exercise after she came home from work.
While still a fellow, Dr. Lohr identified a thrombophilic condition in a morbidly obese patient with venous dermatitis who had three miscarriages and whose brother had died from a massive pulmonary embolism. After diagnosing Factor V Leiden mutation, Dr. Lohr sent the patient to the high-risk OB clinic where she was treated with heparin and then went on to have successful pregnancies. Her children are now in college and getting married. Dr. Lohr looks forward to the yearly Christmas cards she receives from her grateful patient, who credits Dr. Lohr with saving her life and making it possible for her to have a family.
During her successful career, Dr. Lohr was a full partner in the Cranley Group for 10 years and has had a private solo practice for 12 years with a teaching appointment at the Good Samaritan Hospital in Cincinnati. She has run the vascular lab since 1992, where she not only provides excellent
vascular studies and maintains IAC accreditation, but provides an opportunity for various level trainees including ultrasound technologists, medical students, students from junior high, high school, community colleges and universities, as well as general and vascular surgery residents and fellows to learn the most up-to-date vascular investigations.
In addition to a busy clinical practice, Dr. Lohr has continuously served and advocated for her specialty with significant contributions to several surgical organizations. She is currently the associate program director for the Vascular Fellowship and has been the president of Cincinnati Surgical, the American Venous Forum and the Society of Clinical Vascular Surgery, where she continues to be an active mentor. She is quite proud that two of her mentees recently matched in the Zero and Five (vascular residency) Programs. She has traveled to Korea to teach venous surgery and was the invited guest lecturer at the 10th Annual Congress of the Asian Society for Vascular Surgery (ASVS). She is also a current member of the IAC Board of Directors, the ACS Board of Governors, the Executive Committee of the Association of Program Directors in Vascular Surgery and is the liaison to the ACS Committee on Emerging Surgical Technology and Education.
Surprisingly, Dr. Lohr’s entry into the field of surgery did not foreshadow this bright career. After graduating from medical school in 1983, she encountered resistance to the idea of a female surgical resident. Instead, she spent a year at the Marshfield Clinic with Dr. George Magnin, an internist who was sure he could, according to Dr. Lohr, “make [her] an internist or an invasive cardiologist.” Being the resolute learner that she is, Dr. Lohr valued her experience there, as she realized the importance of listening to patients, examining patients, and focusing on their quality of life. She learned that, while our medical technologies might be limited, we can still have a profound impact on the outcomes and lifestyles of our patients.
Dr. Lohr went on to surgical and vascular surgery training, where Dr. William Malarney and Dr. George Just mentored her and fostered her interest in the vascular system, bringing patients from Puerto Rico with congenital anomalies to the hospital for her to care for. She also credits her membership in the American Venous Forum, which has always been a welcoming organization, with encouraging and honing her academic and teaching activities. She was impressed with the ability of Doctors Cranley, Comerota, Kistner and Eklof to simplify even the most complex concepts and make them straightforward. In particular, she recalls the wisdom and kindness of Dr. Tony Comerota, who, as the discussant on the first paper she presented at a national meeting, met with her beforehand to discuss the questions that he would be proposing as well as potential answers. She has continued to follow this example whenever asked to discuss papers and asks her students and residents to present from the podium as a practice session prior to their actual presentations. Adequate preparation in order to achieve the best final outcome is a hallmark of Dr. Lohr’s clinical and academic practice.
Having had early challenges as a female surgeon, Dr. Lohr enthusiastically charges other women to assume leadership roles in vascular organizations. Years ago, while in the ladies’ restroom at a meeting (there was never a line in the ladies’ restroom), she asked another female surgeon why she didn’t belong to the American Venous Forum. Dr. Lohr suggested that the woman explore becoming a member, as it was a very good group. The woman has since become more involved, has been on the Board of Directors of both the AVF and the ACP, and credits Dr. Lohr’s “stalking her in the bathroom” with these accomplishments. Dr. Lohr also points to the success of Julie Freischlag, MD, who will be the first woman president of the SVS, is the president of the Board of Regents for the American College of Surgeons, and is the current Chair of Surgery for Johns Hopkins, as evidence that the glass ceiling is moving. Passionate about encouraging women to become involved and contribute, Dr. Lohr believes that, “If you want to change the future the only way to accomplish this is to be actively involved,” even if one unintended consequence might be to lengthen the lines in the women’s restrooms.
Interestingly, Dr. Lohr’s initial interest was in veterinary medicine. She would likely have become a veterinarian if that education had been offered in Wisconsin. She and her husband, Michael Reardon, whom she met at a Department of Natural Resources Youth Conservation Camp in 1978, have had several four-legged children throughout their lives. Julius Caesar, a 140-pound Rottweiler who thinks he is a lap puppy, is one of many Rottweilers that Dr. Lohr has trained over the years. She continues to work with the SPCA and animal rescue. In addition to the four-legged variety, Dr. Lohr has been the “work mom” for many two-legged students, residents and fellows over the years. Among her other interests are skiing, as well as Wisconsin Badger and Green Bay Packer football—she confesses being a Cheesehead who bleeds green and gold.
Looking back on her career over these past 30 years, Dr. Lohr is satisfied with her choice to specialize in venous disorders. She cites many aspects of her day-today practice, such as the appropriate use of compression, DVT prophylaxis and prevention, DVT treatment, and identification of thrombophilic states for allowing her to
establish long-term relationships with patients and families. These relationships have been extremely rewarding. She says, “This practice has allowed me to have the greatest impact on society, decreasing days missed from work, allowing people to be functional, improving patient functional status and quality of life.”
As she looks to the future, she sees a continuing revolution in knowledge with greater understanding of the scientific basis of venous disorders as well as even greater technical advances, making phlebology an enticing field for anyone entering practice. As her grateful colleagues, we hope that these future phlebologists will have the dedication to learning and excellence in clinical practice, the devotion to making a difference in the lives of their patients, and the commitment to teaching and inspiring the next generation of physicians that has characterized Dr. Lohr’s distinguished career.