By James Guzzo
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February 3, 2023
Chronic venous insufficiency affects 20% of the population, with a wide range of symptoms. If they progress and cause substantial negative impact on your daily activities, exercise regimen, or employment, your primary care team may refer you to a vein specialist, or you may seek one out using the internet. So as the vein space can get quite crowded, a common question may arise, “What kind of doctor am I going to see?” While in the most literal sense, a vein doctor is a “phlebologist,” a number of different specialties can be found offering good vein care, with variable training, skill sets, and certifications. A phlebologist is typically a medical doctor, one that has completed medical school, internal medicine or dermatology training, and has pursued additional coursework and seminars in vein disease. There is an American Board of Phlebology, with certification granted after successful completion of a written exam, but this is not recognized by the American Board of Medical Specialites (ABMS). General surgeons, plastic surgeons, interventional cardiologists, dermatologists, and interventional radiologists all may provide vein care. Although separate and distinct specialties, each requires residency training and often additional training in fellowship programs. These specialties are recognized by the ABMS, and may provide a component of quality vein care as a part of their practice, or solely focus on vein care. However, a common thread of these specialties is that vein care is not the primary focus of their training (e.g. cardiologists focus primarily on the heart, dermatologists on skin, etc). Last but not least, and with obvious bias by the author, are vascular surgeons. These specialists provide expert care for all blood vessel diseases. They typically have five to seven years of general surgery training following medical school, which is then followed by another two years of specialized vascular and endovascular surgery training. This is what sets this specialty apart, as it is the only subspecialty devoted entirely to the care of blood vessel disease. Many of these surgeons incorporate a large portion of their practice to vein care. Because they have the most comprehensive interventional and surgical training, they can offer an unparalleled level of care to patients with vein disease. For example, a medically trained vein specialist may limit their vein offerings as a result of their training and comfort level (i.e. not performing surgical procedures like ambulatory phlebectomy), while a vascular surgeon has no difficulty offering the entire spectrum of vein care, from minimally invasive, catheter-based interventions, to surgical procedures. Is there a best type? Each specialist will obviously have their biases, many will provide quality care, but none can match the breadth of training of a vascular surgeon. As you investigate vein care practices, look at the type of physician or surgeon, their training programs, years in practice, board certifications, professional societies, and accreditations. A little homework will help you find the best match for your vein care. At Precision Vein Care, we are proud to have a fellowship trained vascular surgeon, certified by the American Board of Surgery, and our facility is fully accredited through the Intersocietal Accreditation Commission.