Welcome to the VEIN Magazine Podcast — Real discussions on venous disease and treatment.

Our host Dr. Steve Elias shares some whiskey with Dr. Nicos Labropoulos and Dr. Tony Gasparis while discussing EVM and venous education.

How was the Expert Venous Management course started, how is it different, and what’s in store for 2019?

Episode transcript

Dr. Steve Elias: Okay, well, welcome everybody to what I'd like to call vein specialists sitting around, having drinks, talking. Today we have Tony Gasparis and Nicos Labropoulos talking with us.

Most of you probably do know Tony and Nicos and they have been in the education business for a very long time, running their Venus Symposium in New York City every year. Also, they do a lot of individual teaching at their institution, Stony Brook, as well as all over the world. People come to them and they go to people to help teach.

But we are speaking to you today from the first day after a course that's called Expert Venous Management. It's the first day of the two day course. This course was really started to fulfill a need that we thought existed in the vein world.

Maybe Nicos, can you give us an idea about what is this need? Why do we need Expert Venous Management or a course like that versus the courses that are out there?

Dr. Nicos Labropoulos: I think this is an important course because it takes the people to a different level. First, everybody has an equal opinion, is extremely interactive, it’s not based out of lectures, but real clinical cases that we prepare and other faculty brings. And we discuss the advantages and disadvantages of every technique, approach, outcome, without any hesitation and it’s actually fascinating because people they actually talk and they talk about reality.

We don't always agree with each other but this exactly what medicine all about and it's a course that I really truly enjoy myself.

Steve: If you enjoy yourself then everybody is going to enjoy themselves. Speaking of enjoying yourself Nicos, what do you happen to be drinking at the moment? People might like to know what your choice of beverage is tonight.

Nicos: I'm drinking Stella Artois. It’s one of the beers I like a lot and it happened to be here at the hospital. A beer we cannot have in our own hospital but it's good to be at Jersey for this reason.

Steve: Right. In Jersey we have beer during our hospital. In New York you guys are not allowed to have it.

Dr. Tony Gasparis: No, we're not.

Nicos: They're going to escort you out.

Steve: Now Tony, when we first starting talking about this idea, do you happen to remember where it was?

Tony: It was at VEITH, we were at the lobby having drinks and we talked about putting this course together. I can't remember though, what was the triggering factor?

Steve: The triggering factor was: I said aren't we all bored about giving the same lectures at various meetings, that we've given for so many times, and it's not becoming fun anymore? So I said can we do something that's fun? Do you remember that?

Tony: Well, this course definitely is fun.

Nicos: Absolutely

Steve: Right. It's fun for us, and it's fun, I think, for the attendees.

Nicos: I think the key issue here was the clinical cases because this meeting was truly based on real clinical cases. For example today, you see how animated was the crowd and the person themself telling their story. It's very captivating.

Steve: Yeah it is. Very much so. Now, to put on this course…so, Tony after you take a sip of, what are you drinking?

Tony: I don't know. I was just going to ask you to tell me a little bit about Tin Cup.

Steve: Okay, so Tony is drinking a whiskey called Tin Cup. It's an American whiskey and it says here it is cut with Rocky Mountain water. It's really a mixture of, I would say, between a bourbon and a rye. It's a little sweet but it's American and that's what I like. It's not scotch whiskey, even though I do like scotch whiskey. Tony seems to be enjoying it.

Tony: I enjoy it. It's actually very good.

Steve: I may have to give him another refill soon.

Let’s talk a little bit about the roles each one of us plays here. We all have our little roles before the meeting and during the meeting. Tony, what would you say your role is before the meeting? I could tell you what your role is during the meeting. Which is not to be around during the meeting, but before the meeting what do you see is your major contribution to EVM?

Tony: Well, I'm not going to concentrate on myself, but I think between the three of us, we all put together the program and the topics. At least the type of clinical cases we want to have presented. Other than that, my specific role is mostly organizing the details of putting together the meeting and fundraising for the meeting, as well as marketing for it.

Nicos: I believe that we actually complement each other and we work well together. This is the best fun about this meeting. My role is actually bringing innovation. I try to look here and there to bring new ideas that all of us three approve, and for the most part have worked well. We don't accomplish everything because of the time we have but I think for the most part we do well.

Steve: I do think and I appreciate that you're always challenging us to come up with some new idea. What are we going to do different next meeting that we haven't done already? And I think that's important to keep us thinking ahead.

Tony: Yes, change it a bit and make it interesting, it can be a challenge. But still, other than providing the alcohol and the entertainment during the meeting, what is your role?

Steve: My role, before the meeting?

Tony: And hosting it, I guess, right?

Steve: Yes, it's held here at Englewood Hospital so I guess I do host the meeting. What is my role? I guess I don't exactly know what my role is before the meeting. Whatever you tell me to do, I do. I do...

Nicos: You do deliver I have to ... You do deliver.

Tony: And I love the patients from today.

Steve: Oh yes getting great patients. So yes, we do have live patients here and I kind of work hard to think of the right patient, not just with the right pathology but also the right personality.

Tony: The other nice thing about it is it's a very intimate meeting. We kind of restrict it to about 50, 75 people. Obviously to run this meeting from a financial perspective, dealing with the financials, we do heavily rely on industry and I think they play a very important role to the success of this meeting.

Steve: But the other nice thing when you mention industry about the meeting, what I think they also like, is that it is a non-CME meeting so they're sitting in listening to all the lectures and today for instance, we had comments by multiple representatives from various industries. If we were speaking about a problem, a clinical problem, that involved their technique, that could help and as a matter of fact ...

Steve: A technique that could help and as a matter of fact, who is it from the mechanical firm Beckme said what about a mechanical firm that can be only in this patient that was pregnant and you were a little bit.

Nicos: [Inaudible].

Steve: Right, should I really consider giving thrombolysis in a patient that's 36 months pregnant.

So I thought some of that allows industry, 'cause they have seen sometimes many more cases than any of us have seen 'cause they go to various different physicians.

To me the other nice thing is that industry is involved, not just monetarily, but also they can make their comments without worrying what they can or can't say.

Because in many other meetings they’re not even allowed to come in to listen to the talk so they can't learn, and here we let them learn. And I think what we're trying also to create here is... you can go into a little different area, is the management of vein disease, especially nowadays is a partnership between industry and physicians, and societies.

And the better way to get better partnership is by sharing information and including industry into our meetings in a non CME way we can do that. But with CME for whatever reason they can't, but when they feel part of the whole thing, the whole meeting, I think they're engaged better and it's just good for going forward.

Nicos: Steve I have a question for you here. You've been teaching people and you've taught the fellowship training for a long time, what do you think is the next way in which medicine and industry have to meet? What's the next step? What can we do to do better?

Steve: That's a good question. And I think aside from the meetings like this where people can be more open, as younger people are coming up through training they are very adept at the whole electronic, use of cell phone and electronic devices for learning and stuff like that. I think we, just like here with this podcast.

Because I think people are, I think we're gonna move in that direction, where people are gonna be getting their information more and more...

Tony: Through e-learning.

Steve: Through e-learning, and meetings will be important because there is nothing like one on one, you know, seeing someone in person, but I think this e-learning, done the right way, done in a way that is personal, and not just listening to somebody talk and you fall asleep halfway through it, is kind of the way to go.

Tony: I mean it's definitely a way of providing education, obviously there are limitations on that form, especially if you're doing a podcast where it's just audio versus a video effect.

But also you know how difficult it is to get interaction between the FNDs and the faculty, even in a regular meeting face to face, imagine having to get that interaction over a web. I think it makes it even harder sometimes—especially if there's multiple people in that educational venue.

But definitely it has its role. It does allow you to provide education without having to travel, but there are limitations I think still.

Steve: I agree with you. People get bored if they're just sitting in their house or something listening and they do get distracted. So there may be a way to do it, I'm not sure what, but I think we need to explore that electronic way, e-learning, in some manner or means because I think it can be a more efficient way of supplementing the live meetings.

But I don't think it's ever going to replace live meetings.

Tony: No.

Steve: No because we need the interactions.

Nicos: I think the biggest thing EVM brings, it does put the patient in the center of attention and I think that' amazing by itself.

Steve: Yeah, no, when you bring the live patients here—I think that's an excellent point. When you bring the live patients here and people see then and see what their concerns are it just, doctors we do this all the time, the people that come here they take care of patients all the time, but you're right, sometimes we lose sight of what we're really doing.

Steve: What did we do different this year at EVM that we haven’t done so far?

Nicos: The industry session I think was a good idea, and both of us were going back and forward for a long time, but I'm glad this went through this year.

Tony: So that's like a town hall meeting where we have industry, that's going to be tomorrow of course, and open discussion between them and the attendees.

We have some preset questions that we're going to be asking them, that Steve put together, and then an open forum between the attendees and the industry.

Steve: Right, this again is a theme in trying to incorporate industry in a way they could really have a positive impact, because attendees don't get to talk to industry like this in a forum, they can talk individually, but let's see if industry, we try and get them to open up here.

This meeting, obviously, is a very casual meeting. We tell industry they cannot wear their usual shirt and ties or dresses that they wear, and they come in jeans. And I think it's going to help, and we see how it goes.

Steve: All right, next year. What are we thinking of for next year?

Tony: We're putting the program together right now? Are you putting us on the spot there, Steve?

Steve: No, I want to put myself on the spot also. Right. I want to give people some idea also about how we come up with these things. We kind of bounce different ideas off of each other.

Nicos: What about if we having actually solving a case and separating the people in different teams, and then come up with a solution, and everybody hears what every team has to say about the solution of how they solved the problem?

Tony: We can actually do that during the when session, put a case up-

Nicos: I think it'll be great.

Tony: ... and have each table come up with a solution.

Steve: That's not a bad idea. In other words, right.

Nicos: And hear different expertise, different backgrounds, and have couple cases.

Steve: Right. Solve this case.

Nicos: Yeah. Solve this case.

Tony: So I got another one.

Steve: Go ahead.

Tony: How about have industry bring a case? Talk about getting them involved.

Steve: Yeah.

Tony: So they present the case.

Nicos: No, no.

Steve: No? Why?

Nicos: Because every time we hear industry bringing something by themselves, it's biased, and everybody here is biased against it. Although I like industry participate, not in this way.

Tony: But it could be a case that they were involved with that there was a complication, or something …

Nicos: Usually it doesn't happen this way. He doesn't bring a case …

Tony: So they're not going to bring a case where something didn't go right.

Nicos: No, no, no. They're going to talk to their supervisors or top people and they’re going to selsct … bad business. No, stay out of this.

Steve: They're gonna get what I call industry speak.

Nicos: Yeah, yeah.

Steve: How about we get industry involved with solving a case? So in other words …

Nicos: Yes. This way, yes.

Steve: ... in other words, we have a case, say we present a case of DVT. And we have four or five industry here that treat DVT, okay? Balloons, catheters, mechanical thrombectomies, mechanical chemical. And we put them up on the panel. So the industry that has technology that treats DVT, we put them on a panel, we present the case, and we ask them to see what they would do.

Tony: But even the first one, if we pre-screen the cases and make sure that they're appropriate-

Steve: You're talking about industry's case?

Tony: Yeah. I mean, either way. I'm not having a problem.

Steve: No, I like this other thing.

Nicos: Yeah, I think that's much better.

Tony: That's right.

Steve: An industry clinical panel for a specific disease state. And then for superficial, we could have all the technologies that treat saphenous incompetence and varicosities.

Nicos: Yes.

Steve: That may be good, to get to see what they think. And then they could send their representative that they feel comfortable with. What do you think of that?

Nicos: No, I think that's the best way, because it is eliminates any bias, the people express their opinions, and all the parties are present.

Steve: All right, so I think we have solved the EVM problems. This year everything went well, and I think we have some good ideas for next year. And Nicos is almost finishing his beer.

Tony: Do we have the dates for next year?

Steve: Oh, yes, the dates for next year.

Nicos: Seven and eight.

Steve: It's June 7th and 8th at Englewood Hospital in 2019.

Tony: What are the Venous Symposium dates, Nico?

Steve: Venous Symposium?

Nicos: Venous is April 11, 13.

Steve: 11, 12, 13, and that, aside from this meeting, is the most interactive meeting in the world, isn't it?

Nicos: I think so, because, Steve, thank you for all your help, because you made the Venous Symposium a different meeting. Thank you.

Steve: No, we all worked together. So, yeah, all right, it's good. I think we got some good ideas. Let's wrap up, and we'll see what ideas come to fruition for next year. But good, guys. I think we solved our problems for next year.

Tony: Excellent.

Nicos: Thank you, Steve.

Tony: Thanks Steve.

Steve: Yes. On to dinner.

Learn more about Expert Venous Management and Venous Symposium.

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