How Varicose Veins Referrals From Your Doctor Really Works

How Varicose Veins Referrals From Your Doctor Really Works

How Primary Care Physician Referrals Work When You Have Varicose Veins

Many people don’t know that almost all primary care physicians in Pittsburgh have sold their practices to one of the major hospital systems in our city.

That means that your friendly primary care physician is strongly encouraged and obligated to refer you to a specialist (like a varicose vein doctor) within their hospital network. Their varicose veins referrals are closely tracked.

Your doctor will be reprimanded if they can not justify why they referred you out of their network. In Pittsburgh, the two major hospital networks are UPMC and Highmark.

We accept Highmark BC/BS and also UPMC Health Plan Insurance because I remain independent.

However, once a doctor sells their practice, the doctor is instructed how to refer patients to a specialist.

If your primary care physician does not refer to their hospital’s specialist, there will be consequences.

The referring physician’s referral patterns are closely tracked by the hospital.

They could be fired or their salary could be cut if they consistently refer out of the hospital’s network of physicians.

Quite a few patients have come to me to me recently for a second opinion.

Many work at a local community hospital.  At the present time, that community hospital has not financially totally committed to one of the two major health insurers in our area.

However, physicians in this hospital’s network are told to restrict their referrals to specialists who practice at that hospital.

When a doctor sells their practice, that health insurer that they sold to tells them:  Keep your varicose vein referrals “within the fold”!

However, some smart people do their homework and research the best varicose vein specialist in their area on their own.

In other words, you can self refer the varicose vein doctor of your choice who has the best “word of mouth” and expertise in treating varicose veins.

The Plot Thickens With Varicose Veins Referrals

It turns out that many of the people in my area have been referred by their primary care doctor for their varicose veins to physicians who work for the local community hospital. Unfortunately, these varicose vein doctors have no official training in varicose vein disease.

Therefore, people who have had experiences with this community hospital have complaints about their varicose vein treatments. One complaint is that they are getting the “run-around”. They are sick and tired of being put-off. They are getting lame excuses. They are not being called back after being promised that the doctor would “get back to them” about their varicose veins.

In these cases, usually their varicose veins are so big and the case is so complicated that those doctors just want to get rid of those patients. Either those doctors don’t know how to fix these complicated, huge veins or they don’t feel that it’s worth the effort. Both excuses often fit the bill.

Unqualified Varicose Vein Doctors are Popping up Everywhere

Doctors are flocking to the field of treating veins are like buzzards. Fifteen years ago, it was rare to find a doctor who had any interest at all in treating veins.

However, after attending a three-day conference and watching a few cases, doctors are starting vein practices. That’s right. These so-called vein doctors have no official varicose vein training. However, since the primary care doctors must refer to them, they are seeing patients who are oblivious to these facts.

If you lift up the rotten stump of new venous practices and franchises in this country, you will find a common theme. Doctors are practicing venous disease without any formal training.

Why should that fly in this country?

Wouldn’t you make sure that if you needed a neurosurgeon or heart surgeon that respected national boards of certification properly trained them? Why should the qualifications to practice venous disease be any different?

It appears that treating superficial veins is one-step above the practice of alternative or “complementary” medicine. Normal scrutiny of efficacy does not apply. Normal scrutiny of qualifications does not apply. Normal scrutiny of training in the specialty that you practice does not apply.

This is an appalling practice. Doctors use credentials such as “member of the American College of Phlebology” as a means to promote some type of legitimacy in the field of treating varicose and spider veins.

Beware – Doctors are Good Test Takers

The most popular venous college requires little more than an application fee and the ability to pass one exam to become members. After passing this test, the newly self-proclaimed vein experts advertise these qualifications.

Doctors who state that they are diplomats of venous disease are not board certified in treating varicose or spider veins. It is not real board certification, which means recognition by the American Board of Medical Specialties (ABMS). Chelation therapy is not ABMS recognized.

Their claim of being board certified in venous disease is equivalent to doctors who employ chelation therapy. They repeatedly refer to their board certification in chelation therapy as if that were equivalent to board certification in vascular surgery.

These are games scoundrels play. It is pervasive across this country. It is precisely these types of doctors who are ordering unnecessary testing performed in their own facilities to make a profit.

It is these types of doctors who are also doing unnecessary procedures. I have seen it. It is these types of entrepreneurial doctors who are franchising vein medicine.

As a fellowship trained board certified vascular surgeon with thirty years of experience treating veins, I find this disgraceful. The public has no idea. Calling a vascular surgeon a doctor is like calling an astronaut a pilot.

Conclusion

Medicine has become big business.

Your referral from your primary care doctor may be to a less qualified doctor within their network.

Research your varicose vein doctor or any specialist before you set foot in their office.

Unfortunately, these days you must be on a Quack Watch, even when your primary care doctor refers you to a specialist.

I have not sold my practice nor have any commitments to any insurance company.

We accept both Highmark and UPMC insurance as well as the companies listed below.

I am traditional solo practitioner and am not obligated to any insurance company or to anybody except my patients.

Call us at 724-969-0600 or click here to learn more.

Happel Laser & Vein Center accepts the following health insurance plans.

  • Aetna
  • Advantra
  • Anthem/BCBS
  • Cigna
  • Coventry
  • Devon
  • 4Most
  • Health America
  • Health Assurance
  • Health Plan of Upper Ohio Valley
  • Humana
  • Highmark/BCBS
  • Medical Mutual
  • Mon-Valley Health Plan
  • Multi-Plan
  • Tricare
  • United Health Care
  • Western Pennsylvania Electric (WPEE)
  • UPMC
  • All BC/BS plans

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.