Why Free Varicose Vein Screenings Are a Disgrace

Why Free Varicose Vein Screenings Are a Disgrace

Why Free Vein Screenings Should Be Outlawed – Forever

The real question is – are they really health screenings or just another devious marketing tool of vein center entrepreneur$ ?

Proponents would say that they raise awareness of a true medical problem that may be ignored or neglected. Some patients have been informed incorrectly by their primary care physician and others that their symptomatic varicose veins are just cosmetic.

On the other hand, it is my strong personal belief that free vein screenings are a great enabler of inappropriate care. These unnecessary screenings result in unnecessary ultrasound testing, unnecessary vein ablations, unnecessary sclerotherapy, and unnecessary phlebectomy surgeries to remove veins that don’t need to be treated.

Let’s look a little closer at the accepted truths of health screenings.

Medicare Has Strict Guidelines to Prevent Screenings from Being an Inducement

Medicare wants to know if a doctor is giving something away to entice you to see that doctor. That is a big no no.  Commercial insurance companies also have non-inducement clauses in their contracts with doctors.

If a doctor or their assistants do a free vein screening, legally it must only be an educational visit. Any clinical discussion, ordering of stockings or diagnostic testing is not appropriate and crosses medical-legal boundaries.

The concept of screening for a disease or health issue is to prevent the progression of a health problem or to prevent an unknown medical condition from becoming a more serious affliction that could develop into a crisis.

For example, accepted forms of  medical screening include mammograms to detect breast cancer in its early stages, cervical cancer screening, cholesterol screening, colonoscopies, diabetes and hypertension screening, and abdominal aneurysm one-time screening at age 65. Screening for these important medical conditions is strongly supported by proven medical evidence.

Nowhere in any approved screening program list is the screening for abnormal veins included.

Ever. Never. Not once.

You get it.

William Mayo MD said, the best interest of the patient is the only interest to be considered.

What is the Real Purpose of Vein Screenings?

The down and dirty answer is to bring more potential patients into the vein practice.

They are the medical equivalent of a salt lick to attract deer or chumming the waters when going deep-sea fishing.

Even though venous disease is progressive, it has not been medically proven that screening is ever indicated for vein issues.

How Common is Free Vein Screening?

Vein screenings are pervasive.

If you do a Google search for them, near the top of the list is the vein center for Johns Hopkins’s vein screening program.

Surely, a respectable medical institute like that would not participate in any cheesy marketing scheme.


That led me to continue to do some further internet searches. I got tired of hitting the next button at the bottom of the Google search page after viewing over 250 listings for these screenings.

It’s not just the shady vein franchises that do vein screenings. It seems that almost ever vein center in the country is doing them.

Does that make it right?

At the 2016 International Vein Conference in Miami, a physician panel of nationally renowned experts in the field of venous disease strongly advised against treating veins prohylactically. A question from the audience concerned patients who seek advice for the treatment of asymptomatic varicose veins. Many patients state that they just don’t want their legs to look like their mother’s legs.

The resounding and unequivocal response by the nationally acclaimed vein experts including the venous oracle, Jose Almeida MD, was that preventative treatment of venous disease is not indicated.

By definition, to be eligible for vein treatment, all insurance companies require that your present vein condition must interfere with your activities of daily living. That means that the symptoms that result from your veins must thwart you from working, completing normal tasks and chores or otherwise prevent you from living a normal life.

Therefore, if preventative treatment is not indicated in the opinion of vein experts and not covered by any health insurance company, why are so many vein doctors conducting free vein screenings?

Varicose Vein Treatment is Big Business

Most physicians go into medicine with a mission-driven spirit, committed to helping people. They are grateful for the opportunity to care for others, proud of their ability to diagnosis and treat, and inspired by the trust their patients put in them.

– Malcolm Gladwell

However, in traditional fields of medicine, Obamacare, government and insurance restrictions, the rising costs of running an office, and never ending cuts and lower reimbursements, is demoralizing doctors.

That resulted in many doctors leaving the fields in which they trained like family medicine, emergency medicine, radiology and cardiology into treating veins. Those fields have become increasingly dysfunctional.


Venous disease is treated safely and effectively in the office setting. Venous care has moved out of hospitals.

Before the introduction of minimally invasive techniques such as laser and radiofrequency, varicose veins had to be stripped in the hospital. Credential committees ensured the patient’s safety by allowing only qualified and trained surgeons from performing vein surgery.

Now treatments have moved entirely to the office setting. Office based procedures are totally unregulated by anyone. Doctors from all fields of medicine are learning how to perform vein procedures at three-day conferences.

The flood of new physicians into the vein field has increased the competitive forces between vein practices. Marketing is fierce in the field of venous disease.

Why Do Venous Practices Need Reform?

There is no peer review.

There is no mechanism to report these types of practices that are not practicing in the patient’s best interest. There is no regulatory body for safety and quality in the vein world. This unregulated office environment has no oversight at all from government or consumer safety groups.

In addition, there is no government or consumer agency that can assure that venous Doppler ultrasound testing is being done properly and in appropriate cases. Venous testing is abused.

According to physicians at the latest Miami Vein Conference, there are vascular ultrasound technicians who reportedly will travel to vein doctor’s offices and deliberately falsify tests so that unnecessary saphenous vein ablations can be performed and later reimbursed.

Vein disease is being franchised. With franchised vein care, the mission can be blurred. Is it profit or helping people that is the primary motivator?

A patient with only spider veins recently called my office asking for her records. She said that she understands that spider veins are cosmetic. She knows that her spider veins are not covered but she heard that there is a vein franchise in town that will submit the treatment of her spider veins to her insurance.

That vein franchise openly advertises that 95% of all veins are covered by insurance. The patient knew that was dishonest. However, she would rather not pay for her spider vein treatment out-of-pocket. She knew that she was defrauding the system, increasing health care costs and enabling this vein center to bill fraudulently. But she didn’t care because the bottom line is that she didn’t have to pay for her cosmetic spider veins treatments.

Word-of-mouth of cases like this spread rapidly.

Claims of 95% of veins are covered by insurance by this vein franchise won’t bear scrutiny. It is disingenuous at the very least and fraudulent at best.

Venous disease has been turned into a commodity like pork bellies, orange juice and cotton. All doctors are reimbursed the same for treating veins from the most competent and well trained to the ones who learned how to treat veins at a three-day conference.

Are Free Vein Screenings Really Free?

Free vein screenings are worse and more expensive than you can imagine.

Because these unnecessary vein screenings result in higher costs to the insurance pool, your costs will increase to cover the resulting unnecessary vein treatments and unnecessary testing of others.

Your costs will increase to cover the fraudulent billing of my patient with the spider veins who switched to the vein franchise that billed the insurance company fraudulently.

Your hair should stand on end when these criminal acts are allowed to perpetuate from free vein screenings. Ultimately, you are picking up their bill. Your premiums increase to cover crooked vein centers.


Free vein screenings are everywhere. It seems that almost all vein centers are doing screenings to attract new patients. By attending one, you will most likely be told eventually that you will need either ultrasound testing or a procedure done.

Never ask a barber if you need a haircut.

No one before has ever discussed whether or not vein screenings are ethical.

Since venous disease is not listed on approved screening programs, their purpose to me is obviously blatant marketing and is not health related.

Free varicose vein screenings are worse than you think.

Vein screenings are the following:

  • They are not necessary.
  • They drive up health care costs.
  • They result in over-utilization of care.
  • They are shameful affronts to honest vein doctors.
  • They are crooked, shady, immoral, deceitful, scandalous, and dishonest.
  • They are an indignity and an unworthy insult to reputable vein specialists.
  • They devalue the field of medicine through marketing above improving health.
  • They debase and are an affront to honorable genuine and trustworthy physicians.

Vein screenings are exacerbating the inappropriate use of procedures for profit. They besmirch our honor as ethical and moral healers and are an assault to our noble profession.

They are contrary to accepted venous expert’s opinions who do not recommend preventative vein care.

My opinion is that free varicose vein screenings suck more than the new Star Wars movie.

The Happel Laser & Vein Centre has never conducted any type of vein screening program and never will.

We are the only accredited vein center in Pittsburgh. We are the only vein center in Pittsburgh that has ever been inspected. Call us at 724-969-0600 or contact us here to learn more.

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.