There is a new article in the Consulting Room magazine, featuring Professor Mark Whiteley. In it, he discusses why adding vein treatments to a cosmetic clinical practice might not be as simple as it sounds.
AESTHETIC PRACTICES Vs VENOUS SURGERY
The article explains that aesthetic medicine is relatively new as a medical speciality. It is pushing hard to identify the boundaries of acceptable practice. On the other hand, venous surgery is well established, with decades of research, development, audits regulation and – of course – litigation.
Aesthetic conditions are predominantly assessed visually. They may vary from skin conditions, skin texture, laxity in skin, wrinkles, unwanted hair or unwanted contours. Most have no underlying problems. As such, they can usually be assessed visually and there is rarely a need to perform investigations.
Research into venous conditions has consistently shown that it is impossible to assess leg veins without a venous duplex ultrasound scan. Also, when doctors or nurses do their own scans, they are far less accurate than when done by a fully trained vascular technologist. Research presented in the Veith conference in New York in 2013 showed that doctors who performed their own scan missed at least 30% of the underlying causes of leg vein problems. Adding to this, the NICE Guidelines clearly state varicose veins should be assessed by a vascular service. This is defined as a group of professionals, and NOT a single doctor doing their own scans and offering whatever is their preferred treatment.
SUCCESS, FAILURE & COMPLICATIONS
In the article, Prof. Whiteley also explains that in aesthetic clinics, success or failure is usually subjective. In addition, few cosmetic clinics perform research, audit their results, nor offer an out-of-hours emergency service.
When considering venous treatments, veins are part of the circulatory system. Complications such as blood clots or infections can be severe or even life-threatening. Hence, if aesthetic clinics want to start offering these services, they need to make sure that they have covered all possible risks and patients have a clear and safe service – including out of hours emergency cover
Those with no background to venous surgery will be surprised at the workload generated by either complications, or the fear of complications.
NEW TREATMENT OPTIONS FOR VARICOSE VEINS
To add to the factor of ever evolving practices, the world of venous surgery is no doubt moving on at a great pace. This year alone, Professor Mark Whiteley performed the first Endovenous Microwave Ablation of varicose veins in Europe and introduced Echotherapy treatment (SONOVEIN) in the UK. Currently this non-invasive treatment option, utilising High Intensity Focused Ultrasound (HIFU), is only available to patients at The Whiteley Clinic.
There is concern in the venous world that Aesthetic Clinics might offer more venous services for leg veins, mistakenly considering them to be an aesthetic condition.
NICE CG168 COMPLIANT
The featured article in the Consulting Room magazine should be read by anyone who is either considering bringing veins into their clinics, or by those that already have done so. A practice or clinic needs to fully understand the responsibilities undertaken when moving their practice from aesthetic clients to venous patients. They also need to check that they are compliant as vascular services as defined by NICE CG168.