Establishment of a Varicose Vein Center in a Tertiary Vascular Surgery Practice: Urban Versus Rural Differences

Incorporating outpatient venous procedures into a vascular surgery practice

The use of endovenous procedures to treat superficial venous reflux disease in an exclusively outpatient setting has been growing in popularity during the last decade. Incorporating outpatient venous procedures into an existing vascular surgery practice is a logical step and provides optimal patient care by using the combined expertise and knowledge of devoted vascular surgeons and dedicated supporting staff. This affords the opportunity to treat patients comprehensively and to streamline the evaluation and treatment process for patients with virtually all stages of chronic venous insufficiency. Successful establishment of an outpatient vein care clinic involves making well-informed decisions about workspace, staffing, acquisition of equipment, optimization of reimbursement, and patient recruitment. Separation of the venous practice from the arterial practice both geographically and temporally is critical to success because the clinical and operational needs of these two groups of patients are very different and because the vein practice in many situations may become so robust that it erodes physicians' participation in the arterial side of the vascular practice. In addition to favorable clinical results and increased patient demand, procedures performed on an outpatient basis can be expected to significantly increase revenues. With proper strategy and organization, an outpatient vein practice can round out the existing vascular practice and be a profitable adjunct to an already established vascular surgery practice.