How to Choose a Vein Center That Has Been Inspected and Accredited

How to Choose a Vein Center That Has Been Inspected and Accredited

How Important Is Vein Center Accreditation?

Sometimes we expect things and services have been inspected but we don’t give it much thought. Vein center accreditation and inspection is one of those things.

However, what would the world be like if the following inspections never took place?

  • What if millions of Americans drove cars that were never inspected?
  • What if the planes that we fly in were never assessed at regular intervals?
  • What if the home that you intended to buy wasn’t inspected first?
  • What if they didn’t regularly assess and inspect the hospital where you need surgery?

What about the things we expect that need inspected like:

  • Water quality
  • Oil rigs
  • Banks
  • Roller coasters
  • Fire extinguishers
  • Car emissions
  • Hair salons
  • Nail salons

Should vein centers be exempt?

Of course not!

Then why are there so many vein centers operating where no inspector has ever set foot?

There’s the conundrum.

Here’s the answer.

Before 2000, Varicose Veins Were Treated Only in Hospitals

That’s all changed.

General anesthesia is no longer required. The standard of care is for vein treatments to be done under local anesthesia in the office.

Varicose vein treatment has moved from hospitals to doctor’s offices. That left the office environment totally unregulated.

Happel Laser & Vein Center remains the only accredited varicose vein center in Pittsburgh that has passed a rigorous inspection using respected national standards.

The IAC accreditation is the only “Seal of Approval” that all patients can depend on to assure quality in this outpatient setting.

Vein procedures have increased 1600% in the past ten years. That rate of growth is unsustainable.

Corners are being cut.

Health insurance companies are determining medical necessity instead of doctors.

Substandard vein centers are increasing because of dissatisfied doctors switching into treating veins with no training or experience in the field.

Many self-proclaimed vein doctors learn about veins after attending a three-day weekend conference.

What Does the IAC Vein Center Accreditation Mean?

The IAC (Intersocietal Accreditation Commission) bestows accreditation only to those facilities that are found to be providing quality patient care, in compliance with national standards. There is a thorough and extremely comprehensive application process.

Quality benchmarks are now being evaluated on training, procedural volume, qualifications of all the personnel including the physicians, safety of the facility and outcomes.

That includes an exhaustive review of selected patient procedures. An on-site examination similar to those required by hospitals has been given and must meet national standards.

IAC accreditation is widely respected within the medical community, as illustrated by the support of the national medical societies related to superficial venous disorders, which include physicians, physician extenders, nurses and ultrasound technologists.

IAC accreditation is a “seal of approval” that patients can rely on.

It is an indication that the vein center’s processes and procedures have been carefully evaluated by true medical experts in the field of superficial venous disease.

At the present time, accreditation of vein centers is voluntary in Pennsylvania. Blue Cross Blue Shield of Massachusetts requires vein center accreditation for reimbursement. This is an inevitable step towards mandatory regulation of previously unregulated vein care done in vein centers outside of a hospital setting.

The History of Vein Center Accreditation

In 2010, the American College of Phlebology and the Society of Vascular Medicine began talks on accrediting vein care in this country. Because any physician with a valid medical license can treat veins in their office, there was a dire need to set up standards to regulate venous care in the U.S.

The IAC already had over twenty years of experience and was widely recognized and respected in credentialing other medical fields. A multidisciplinary panel was organized to oversee this venture to shore up quality in vein care that did not exist at all prior to this undertaking.

In 1990, the IAC was founded.  At that time, it was known as ICAVL (the Intersocietal Commission for the Accreditation of Vascular Labs).  Vascular ultrasound is integral to the diagnosis and the treatment of venous disease so it was a natural fit that it should oversee this effort.

The IAC is sponsored and involves the oversight of over 36 medical societies that are directly involved in some aspect of vein care. Some of these institutions include the American Venous Forum, the Society of Interventional Radiology and the American College of Venous and Lymphatic Medicine.

Initially this newly created entity decided to restrict its authority to the treatment of superficial venous disease like varicose veins. Their goal was to construct minimal standards of venous care. Approved centers were not to promote themselves as “centers of excellence”.

The first meeting of this board was in June 2012. The board was all-inclusive. It was decided to include all the societies involved in any aspect of vein care. Standards were drafted in June 2013 and published on October 1, 2013. Applications for vein centers to seek vein center accreditation voluntarily were begun on November 4, 2013.

Standards included requirements of the vein center’s medical director, its personnel, the equipment and medications, and the volume of venous work done at each center. Larger case volumes of any procedure have a direct correlation to good outcomes.

Emergency equipment, autoclave and sterilization and all medications are carefully examined. Standards for ancillary personnel including continuing medical education are scrutinized.

Quality assessments and quality improvement play a large role in vein center accreditation. Ultrasound laboratory accreditation is necessary because venous Doppler is integral to the practice of varicose vein treatments.

Administrative policies and protocols for procedures are analyzed. Patient identification protocols and universal protocols that hospitals use are analyzed. This includes OSHA guidelines and infection control in accordance with Center for Disease Control standards. The use and maintenance of all medical equipment is directly inspected. Entrance into a national registry to analyze procedures and monitoring performance and results are mandatory.

An on-site inspection examining all the aspects of care including saphenous vein ablation, sclerotherapy, and ambulatory phlebectomy are observed and assessed.

Deficiencies are discussed to improve the quality of care.

The process is extremely thorough and exhaustive. Reviews every six months are required. Peer review of complications and outcomes as well as the proper indications for treatment are performed regularly.

Do We Need More Regulation?

Requiring accreditation of vein centers is a very good thing.

There must be a minimum standard of care and quality just like in hospitals. Why should an outpatient vein center where procedures are done be held to a lower standard?

At the present time, you can have vein procedures performed at vein offices that have never been inspected.

That is unsafe.

An accredited vein facility can answer the following questions affirmatively.

  • Are the autoclaves sterilizing the instruments properly?
  • Have the doctor’s credentials been checked?
  • Is the emergency medical team and equipment ready and are protocols set up in case of a medical emergency?
  • Is continuing medical education up to date?
  • Are the medications used FDA approved?
  • Are the equipment and fibers used FDA approved?
  • Have the lasers and radiofrequency generators been inspected?
  • Are there quality assurance controls and a quality improvement program in place?
  • Has an on-site inspection been done by a nationally recognized team of experts in the field?
  • Are the quality improvement measures in place being updated regularly?
  • Are outcomes being reported?


The Happel Laser & Vein Center is the only IAC accredited vein center in Pittsburgh. It was the fourth vein center in the United States to become an accredited vein center.

That means that Happel Laser & Vein Center is the only varicose vein center in Pittsburgh that has ever been inspected.

Heck, they inspect cars, jets, restaurants, hospitals, and even nail salons.

Would you ever use those services knowing that they have never been inspected?

Of course not.

Why should vein centers be exempt from inspections?

It’s ludicrous. However, don’t feel bad if you weren’t aware of this.

Even health care personnel who work at other vein centers don’t understand that their vein center is not accredited.

In Pittsburgh many other vein centers have accreditation only in Doppler ultrasound from the IAC.  Happel Laser & Vein Center is the only entire vein center in the city that is accredited. That is very important to know when choosing a vein center.

Let that sink in for a second.

John Happel MD is the director of the only vein center in Pittsburgh to be granted full accreditation in Varicose Veins and Superficial Venous Treatment and Management by the Intersocietal Accreditation Commission (IAC).

When scheduling a vein center procedure, you should always first inquire into the accreditation status and the inspection status of your chosen varicose vein center.

Call us at 724-969-0600 to learn more about accredited vein centers or to make an appointment to have your veins treated.

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.