Yawn, Why Should You Care About the Credentials of a Vein Doctor?

Yawn, Why Should You Care About the Credentials of a Vein Doctor?

Patients Don’t get It – Some Vein Centers Try to Exploit That

Why Credentials Are So Important in Phlebology (Veins)

The problem when looking up the credentials of a vein specialist is that there is no special training, residency, or fellowship in just venous disease alone.

The closest thing to a vein training program is a vascular surgery fellowship.

Vascular surgery is much more rigorous in its demands on the doctor than most other specialties. Vascular surgeons by necessity must be perfectionists. They are often micro managers.

When Medicare recently sought input regarding reducing future reimbursements for varicose vein conditions, who did they call on to testify?

Vascular surgeons.

Dr. Peter Glovikski and Dr. Michael Dalsing specifically.

Medical students often dread the demands of their vascular surgery rotation.

It’s tougher.

Vascular surgeons are referred to – by medical students – as the bad asses of medicine.

Their patients have more critical medical problems and are sicker.

How Are Vascular Surgeons Different?

On average, vascular surgeons work 61 hours per work week. They are on-call approximately 2.7 nights per week and spend about 20 hours per week in the operating room.

A vascular surgery fellowship also includes mandatory ultrasound knowledge (RPVI certification) just to sit for the vascular surgery boards.

Venous ultrasound is critical in both the diagnosis and also during the actual treatment of your varicose veins.

Compare the overall demands of vascular surgery training to that of any other specialty from which doctors come to treat veins.

An example is the quality of vascular surgery research.

Compare the rigor of the scientific papers presented at the American Venous Forum, comprised of almost all vascular surgeons, to those presented at the American College of Phlebology.

At the latter, there are different doctors of varying backgrounds and experience in treating veins.

You may be aware that other specialists also treat veins in this country. That includes interventional radiologists, cardiologists, emergency medicine doctors, and even family practice doctors.

Each of these specialties have significant deficiencies in their training programs for doctors who want to specialize in treating veins.

This article is all about differences.

Let me give you a final example of the differences in demeanor. Vascular surgery’s sartorial choice is wearing coats and ties at their conferences.

This is in stark contrast to the attire seen at phlebology meetings where it’s not unusual to see flip flops and cargo shorts as the attire du jour.

Treating Veins is Complex Because Venous Disease is Complex

It’s not well known that the treatment of varicose veins is palliative and rarely curative.

Varicose veins will often stay away years longer if they are treated completely and meticulously the first time.

Trying to inject massive, huge varicose veins doesn’t work well.

These large veins often recur after sclerotherapy, stain the skin for long periods of time and hurt for weeks after the injections.

Many radiologists, cardiologists, and all emergency medicine physicians have no experience at all with phlebectomy during their training.

Do you want them learning on you?

 Vein Doctor’s Credentials Don’t Imply Integrity

No discussion about a vein center or vein doctor’s credentials would be complete these days without mentioning ethics.

Because of ethical abuses in treating varicose veins, phlebology is losing its credibility.

A phlebology certificate doesn’t guarantee that that doctor will treat you without any consideration of self-interest.

We all have a moral code. It is up to you to decide whose you will accept when seeking vein care.

In general, the closer that a vein office morphs into to a business model, the more you have to be suspicious.

There is no doubt there’s a gradual erosion of moral and ethical values in this country. This involves the medical profession as well.

Shootings at schools, daily terroristic attacks, designer drugs in schools, and even road rage are all taken for granted. Parents have to pick their children up at the bus stop. That hasn’t always been the case in case you’re a millennial or generation Xer.

On A Lighter Note

We live in age where:

  • Doctors don’t make house calls anymore
  • We speak in Emojis instead of using nouns and verbs.
  • Our attention spans are limited. The average time people spend looking at a web site is eight seconds – less than the attention span of a goldfish.
  • Where pizza gets to your home before the police.
  • Where cigarette machines, phone booths, and aluminum ice cube trays no longer exist.
  • Neither do TV test patterns, cap guns, Earl Scheib car paint jobs or home milk deliveries.

By the way, if you remember these things, there’s a greater chance that you have varicose veins. After all, age correlates with varicose veins.

Posted by Do You Remember? on Wednesday, February 8, 2017


Calling a vascular surgeon a doctor is like calling an astronaut a pilot.

That being said, not all vascular surgeons are interested in treating veins. There is no substitute for experience.

Vein franchises believe that patients are rubes because most people just choose the closest vein center without any regard to the doctor’s true qualifications or credentials. That’s a fact.

Unless you have a feel for how medical specialties differ as described in this article, it’s harder to find a vein doctor with the best credentials.

We are flooded by claims of the best of the best and the worst of the worst.

Despite differences in training, it’s still possible to find the best vein credentials if you do your due diligence and investigate your choices thoroughly.

Don’t take for granted or assume that all vein doctor’s credentials are the same.

Far from it.

Say goodnight Gracie.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.