Dr. John Happel | Sep 22, 2018 | 0
Outrageous Deeply Disturbing Facts About Pittsburgh Vein Centers
What No One Tells You About Bad Vein Centers in Pittsburgh
You Won’t Believe What is Happening Behind the Scenes in Our Vein Centers
Those are strong words, so let me explain.
It all starts with a falsified Doppler ultrasound report.
I regularly see patients for a second opinions about their veins. Many have already been to a med spa or a vein franchise.
Usually they bring their Doppler ultrasound report from the first vein office. I personally operate the ultrasound machine and redo the actual test myself. That way there is no question.
The credential to perform venous ultrasound is the RVT (registered vascular technology) certificate.
I am the only Pittsburgh physician to obtain all of the essential ultrasound credentials. I also have the credential to interpret vascular ultrasound. That is the RPVI (registered physician vascular interpretation) certificate.
When patients present with only visible spider veins and the Doppler test from the other office shows four abnormal saphenous veins, I know that there is a problem with the testing.
The saphenous vein is often abnormal when a patient has varicose veins.
Not with spider veins.
After seeing this inappropriate practice pattern many times, I suspect foul play. The test has been falsified to justify unwarranted procedures.
It’s the same vein offices that habitually transgress.
Round up the usual suspects.
I am not the only vein doctor who has experienced these absurd vein center abuses from wannabe vein doctors.
Every Vein Doctor Must Be Credentialed to Perform and Also Interpret Venous Doppler Ultrasound
Physicians who are not to be able to verify the veracity of this critical test themselves is inexcusable or more accurately – incompetent.
That’s giving them the benefit of the doubt. Usually they know the underlying forces that exist in that office to generate more income.
It is a national problem. It’s not just occurring in Pittsburgh.
There are strong competitive forces in the field of treating veins.
Why such strong competitive forces?
Doctors in droves are switching to treat in veins in their unregulated offices.
What’s the reason for this Kafkaesque metamorphosis?
Insurance companies are cutting covered services in many other medical and surgical fields. The number of varicose vein treatment centers has exploded at an unbelievable rate over the past ten years.
There seems to be a vein center on every corner – like Starbucks. The field is inundated.
You have probably noticed this already.
Minimally invasive catheter and laser techniques have replaced the painful stripping surgery. Untrained self-proclaimed vein experts are learning how to treat veins after attending a three-day weekend course.
They call themselves phlebologists – just to warn you.
The reason for this is that abnormal veins are very common. Over fifty million people in this country have varicose veins. New technology makes this possible.
Supply and demand, don’t cha know?
There is no oversight at all in doctor’s offices. To put it bluntly, some vein offices are just plain crooked.
Many doctors who work there are just incompetent because they can’t check the Doppler results themselves before they destroy normal veins. That’s being generous.
That’s patient abuse.
Legally, it’s assault and battery.
These Tips Can Help You Avoid a Corrupt Pittsburgh Vein Center
#1 Does the Vein Office Offer Groupons for Spider Veins?
This is a tell-tale sign of a sketchy vein office. The con is to offer spider vein services to lure people in for a Doppler ultrasound.
Here’s how the bait and switch works.
First, they offer spider vein treatments for an incredibly low price.
For spider vein treatments, there is no profit after the Groupon discounts. When the patient presents for their consultation, they are told that a Doppler ultrasound must be done before the spider veins can be treated.
That’s the bait.
(Doppler ultrasound is not necessary for spider vein treatments.)
Since the patient does not know this, they consent to the testing. Most make a quick decision. “I did what they said, I trusted them” is what people tell me.
Inevitably the test comes back showing falsified reflux in the saphenous vein. This the patient is told that their condition requires laser or radiofrequency ablation of these underlying larger veins which caused the spider veins. Not true.
That’s the switch.
They are told that insurance will cover the big saphenous vein ablation(s). “Insurance covers it” is the lie.
Many of these places “generously” waive the deductible, co-pays and co-insurance. That is not permitted by law, by the way.
They trust the office and have the veins that are used for heart bypasses eliminated. These procedures result in a windfall of thousands of dollars for every obliteration procedure done on each of these underlying normal veins.
Gullible patients fall for this. The smart ones go for a second opinion. If they do their research, they can find a credentialed and competent vascular surgeon who can give an honest opinion.
And to top it off, after the saphenous veins are destroyed, the spider veins never change in appearance at all by these saphenous vein ablation procedures alone!
Some Pittsburgh vein centers also bill insurance companies fraudulently for spider vein treatments.
No insurance company ever pays anything for cosmetic spider vein treatments that don’t cause symptoms.
Spider veins are never a covered service unless they bleed.
Insurance companies require photographs of the veins that are to be treated.
These dishonest places swap phony pictures from other patients with big varicose veins and submit them to the insurance company to get away with the deception.
I’ve seen it from patients who come for another opinion.
#2 No Inspections Ever Done at the Vein Center
- Hospitals are inspected
- Restaurants are inspected
- Cars are inspected
- Jets planes are inspected
- Banks are inspected
Why aren’t vein centers inspected?
They are – but it’s not mandatory yet.
The commission that inspects vein centers just started doing inspections three years ago. Only in Massachusetts are inspections linked to reimbursement.
Happel Laser & Vein Center has voluntarily become the only accredited and inspected vein center in Pittsburgh because it’s the right thing to do.
Would you eat at a restaurant or fly in a jet knowing that they have never been inspected?
Why would anyone go to a vein center knowing that their equipment, staff, doctor and safety equipment have never been examined or inspected?
No insurance company ever would come to the vein center to audit and actually reexamine a patient.
I unsuccessfully tried to have credentialed auditors from the IAC do exactly this during our routine on-site inspection.
The bottom line is that no one will check the accuracy of the Doppler ultrasound test.
Predatory doctors and vein franchises know this. This is the overwhelming inherent weakness of the system.
There are absolutely no checks and balances in vein centers where all varicose and spider vein treatments are done.
Fraud is the result.
If a vein center has to advertise, there is a problem.
Word-of-mouth dictates that the best doctors don’t need to advertise to get more patients. People know who the best professionals in any given field are.
Social media is the latest form of this word-of-mouth. Customer satisfaction drives it.
Buzz is created when someone has a good experience. Television or radio can’t replicate its authenticity.
Many people assume correctly that a doctor’s office that has to resort to paid advertising when it can’t generate the word-of-mouth unpaid advertising that results in satisfied consumers.
When broken down, it was found that 75% of word-of-mouth is face to face, 15% occurs on the phone and 10% is the result of an online experience.
#4 Unnecessary Venous Doppler Ultrasound Testing Can Lead to Unnecessary Surgery
You know that you’re in a sketchy vein office when – mandatory and unnecessary Doppler exams are ordered routinely on any every warm body who walks into the consultation –whether they need it or not.
If you have spider veins, you don’t need a Doppler ultrasound test!
The main purpose of that test is to look for blood clots or to look at the saphenous veins.
The saphenous veins don’t need to be treated in patients who have only spider veins.
If the doctor suspects that there may be an underlying saphenous vein problem, the doctors themselves should only do a five-minute quick screening of those veins and not charge your insurance company $250.
That’s what I do.
I don’t order Doppler exams on patients with spider veins.
It’s an unnecessary expense.
Asymptomatic patients with only spider veins don’t need their saphenous veins treated.
So why order a Doppler ultrasound test which is meant to examine the saphenous veins?
After the Doppler ultrasound test, many vein centers tell their patients with spider veins that they need a saphenous vein procedure like laser or radiofrequency.
That is unnecessary surgery.
#5 Multiple Satellite Offices (a wide net)
Vein franchises and spas have to throw out a wide net to feed the multitude of staff and employees to keep their doors open.
One trick they use to get more people in their doors is to make many locations convenient and close to where you live.
People prefer to choose a place that is close to their home.
The business solution is to sublet multiple offices from other doctors a couple of days per week all over the city of Pittsburgh.
However, when it comes to procedure days, you will be switched to a central location that is convenient for them.
You assume that the procedure will be done in the office where you have your initial consultation. That is rarely the case.
#6 Med Spa Vein Center
Is a med spa vein center the appropriate place to have vein procedures and operations?
There are risks to vein procedures.
The place where you have facials, manicures and pedicures is not where you want to have safe and effective medical procedures.
When procedures are performed that break the skin’s surface, you have become a patient.
You have to ask yourself are you taking it seriously enough?
#7 Sketchy Doctor’s Credentials
You want a trained vein doctor.
Not one who is learning on the job.
On the job training doesn’t cut it when dealing with people’s varicose veins.
Only board certified vascular surgeons are trained in every aspect of venous management.
Beware of self-proclaimed vein experts who call themselves phlebologists.
What are they really board certified in?
Don’t accept the words, board certified, alone.
Dig deeper. In which field are they board certified?
Do some research into your vein specialist’s credentials.
Are they proficient and certified in all aspects of vascular ultrasound?
Doppler ultrasound is critical to the diagnosis and the treatment of varicose veins.
There are three types of doctors who perform unnecessary vein procedures:
- the immoral
- the indifferent
- the incompetent
If you suspect that the recommended vein treatments are overly aggressive, always get a second opinion.
Report suspected offenders to the state medical board or to your insurance company.
Unfortunately, these cases are difficult to prosecute. The upside benefits outweigh the risks of prosecution.
That often makes it worth the risk for the offenders and they know it.
Randy Harwell, the civil division chief for the U.S. attorney in central Florida discussed the difficulty prosecuting medical fraud. He said,
“We look for cases where, based on an examination of records and claims data, the (surgery) numbers are so out of whack with a physician’s peer group that it counters that presumption that we typically give a doctor to make judgment calls. It’s quite difficult in a medical necessity case to get to a place where all those things come together … to paint a picture where (the doctor) is actually sinister.”
Believe me, this problem also exists right here in Pittsburgh.
I see it first hand from people who have been seen at these other vein centers.
I hope that by increasingly writing about it that people will be forewarned.
Read more about how to choose the right Pittsburgh vein center.
Call us at 724-969-0600 or click this link to learn more about varicose vein center abuses.