What Type of Doctor Should Treat Your Leg Varicose Veins?
So who should treat your varicose veins? A nurse? A cosmetologist? A medical assistant? A technician at a medical spa? A physician specialist? A board-certified doctor?
This is one of the most common questions that patients ask their primary care doctor or friends when they determine that they wish to have their leg vein problems addressed. And in my opinion, this is the most relevant and important question for a potential patient to ask before they make an appointment to have their veins examined. Why so important? Because there is honestly very little regulation or consumer protection when it comes to clinics performing vein treatments or vein procedures, whether they are qualified and capable or not. Any medical clinic or spa can hang a sign on their building advertising that they are “vein clinics,” yet they are not required to have any formal training or certifications before doing so. In other words, consumers beware.
It has been my experience as a physician of many years that most patients assume that there are regulatory healthcare agencies, medical boards, or government agencies within their communities that protect them from poorly trained or unqualified individuals performing “specialty procedures” or from falsely advertising their qualifications. Although these types of protections are often in place within hospitals, there are not such methods of consumer protection when it comes to stand-alone healthcare clinics and medical spas. This translates into there being thousands of “vein clinics” that are poorly staffed with inadequately educated and trained individuals. So unless you do your own due diligence and research, you can end up in a situation that you will later regret.
Many of the healthcare facilities that establish themselves under the identity of a “vein clinic” or “vein center” are staffed by healthcare staff that has NEVER undergone any formal medical training in vein or vascular diseases. Most of these facilities are managed by physicians that have NOT completed a medical residency or medical fellowship in vascular surgery or vein surgery and are therefore NOT recognized as being board-certified in the field of vascular by the American Board of Medical Specialties. As a result, the level of care received at these facilities is often poor. And unfortunately, many patients don’t realize this until it is too late . . . after they have undergone treatments with poor outcomes and worse yet, significant complications.
As a well-established doctor of the Texas medical community that has practiced throughout this state, I have come to the surprising realization that the majority of facilities that are performing vein procedures in Texas are run by physicians that are NOT board-certified by the American Board of Medical Specialties in any field related to the comprehensive management of a vascular disease or vein disease. Most of these facilities are run and managed by radiologists, family practice doctors, dermatologists, and general doctors . . . but NOT board-certified vascular doctors or board-certified vein doctors. Why? I believe that the shortage of qualified vein doctors and the high demand for vein services is one of driving factors. This is also the reason that many of the facilities that perform vein procedures are med spas that have technicians or nurses performing vein procedures rather than physician specialists.
As a result of this dilemma, medical communities nationwide are frequently seeing poor quality vein care being delivered to their communities. So what is the solution? How can YOU be assured that you are being treated by an appropriately trained and qualified individual? First, you assure that the individual who is treating you is board-certified in Vascular Surgery by the American Board of Medical Specialties (ABMS has been the accepted national standard for physician certification in the USA since 1933). Vascular Surgery board certification is the only avenue through which an individual can achieve ABMS board certification in the comprehensive medical and surgical management of vascular and vein conditions. In other words, this is the only medical university-based pathway through which a physician can be classified by a legitimate medical board as a Vein Specialist with board certification. It is the only way for a physician to complete an approved residency and fellowship program in vein diseases so that they are appropriately educated, trained, and qualified in managing all forms of vascular and venous diseases. Bottom line: seek out a board-certified Vascular Surgeon to treat your vein disease. This is the only way to be assured that you are being treated by an appropriately educated and trained individual.
I have personally witnessed dozens of situations in which an individual is referring to themselves as a “vein specialist,” yet when I asked them at which university they trained to achieve their board-certification in vein diseases, or when I ask them at which hospitals they did their vascular residency and fellowship, they then turn around and admit that they really are not board-certified or even formally trained in vein disease management. Rather they merely have an “interest” in the field but have never pursued the formal university and hospital training that the medical community and patients expect of them. And I have also had the unpleasant experience of meeting many patients who have been harmed after receiving inappropriate treatments for their varicose veins by unqualified individuals. You don’t have to become one of these victims. Educate yourself.
In addition to seeking out a medical facility that is managed by a board-certified Vascular Surgeon, another important factor to consider is WHO at that facility is going to personally be seeing you and who is actually performing your procedures. Is it an assistant to the doctor (a physician assistant or nurse) or is it the physician themselves? Obviously, you would expect that it will be the physician specialist. But at many of these facilities, that is not the case. So always ask that question.
Although leg varicose vein treatments may appear at the surface to be a minor procedure to go through, an elective office procedure can turn into a major medical problem if it is managed inappropriately. As a vascular surgeon, I have been referred to many patients with varicose veins that were inappropriately managed by other individuals. These inappropriately performed procedures resulted in significant chronic leg problems that were completely avoidable. This includes patients that developed major blood clot complications, nerve injuries, and skin ulcers as a result of their poorly performed leg procedures.
So in summary, the question should not be “Who is allowed to treat varicose veins?” but rather “Who do you want treating your varicose veins?” The answer I always give is a very simple and accurate one . . . ” A Board-Certified Vascular Surgeon . . . period.” Vein disease management is a complex field that requires a high level of knowledge and skill in order to be a competent provider of vein services. Expect your doctor to be appropriately trained and qualified. Don’t be afraid to ask the appropriate questions. It is your body and you only have one. Take responsibility for your health.
I hope you found this article to be helpful.
Joel Gotvald, MD, FACS, RPVI
Board-Certified Vascular Surgeon