The Whiteley Protocol® is used exclusively by the doctors and vascular scientists working or training at The Whiteley Clinic and it ensures that patients get the same excellent standards of care, whoever they see at The Whiteley Clinic.
As technology and research are moving forwards so rapidly, The Whiteley Protocol® is being continuously reviewed and updated as new discoveries, new data and new equipment and techniques become available.
Thus those training at The Whiteley Clinic are taught the basics of the Protocol, but unless they work within the clinic, they will not have had time to learn the whole protocol, nor be kept up to date with the latest developments and changes to The Whiteley Protocol®.
We are hopeful that in the future, doctors, clinics or hospitals that wish to provide the very best vein treatments to their patients will work with us so that their staff use The Whiteley Protocol® and have continual updates to ensure that as this exciting area of medicine progresses, they continue to provide the level of investigation and treatment directed by The Whiteley Protocol®.
To be able to provide the best in vein care to patients, there is a basic requirement for:
1) All patients to have a venous duplex ultrasound performed by a specially trained venous vascular scientist or similar specialist, using a high resolution duplex ultrasound machine.
There has been a trend for some doctors to “do their own scans” using small portable scanners – although this makes commercial sense to the doctor, it is not possible to develop enough expertise in scanning veins to the level that we require in The Whiteley Clinic nor to use The Whiteley Protocol® unless one is doing venous scans all of the time – hence if they are also operating and seeing patients in outpatients then they will not have enough continual practice and experience to scan to the required levels for The Whiteley Protocol®.
Similarly, vascular scientists that scan all of the time but work in big vascular units where the majority of the work is arterial, do not get the experience to scan enough veins to be able to pick up all of the venous problems that we find in patients coming to The Whiteley Clinic.
Hence we require dedicated vascular scientists who perform venous scans using methods dictated in The Whiteley Protocol® for at least 80% of the whole working week using the highest resolution duplex ultrasound equipment.
2) The availability of all of the modern technologies to treat veins – as different techniques are required for different veins and vein patterns
The minimum required to be able to adequately treat all patients presenting adequately would be to have endovenous laser (EVLA), radiofrequency ablation (RFA), Ultrasound Guided Foam Sclerotherapy, TRransLuminal Occlusion of Perforating veins (TRLOP*), coil embolisation of pelvic veins and ambulatory phlebectomy – all of which should be performed under local anaesthesia as walk-in walk-out surgery.
* TRLOP is often misnamed ‘PAPs’ or Perforator Ablation Procedure by the Americans. TRLOP was invented by Mark Whiteley and Judy Holdstock in 2000. Mark presented TRLOP in San Diego in 2003, Marcos Island in 2004 and Miami in 2005 – and then when giving the latest results at a meeting in Miami in 2006, the same technique was presented and ‘new’ and called ‘PAPs’ by one of the panel who had been at the 2005 meeting!!! By that stage TRLOP had been established for 5 years!
3) Doctors who are dedicated to understanding the way that veins work and how they go wrong – and how they can best treat them.
For many years, the way veins work (called the physiology of veins) and the way that they go wrong (called the pathophysiology of veins) has been taught simply. Over the last two decades, there have been huge leaps in understanding of how veins can go wrong. It is essential to understand this and to use this knowledge in diagnosing every patient who comes the treatment. With all of the different techniques required to treat all of the different patterns of disease, and all of the understanding that is also required, we believe that for a doctor to be adequate at treating venous conditions to the level that we require, they need to be spending at least 50% of the time treating veins. With an understanding that the more the treat venous problems the better they will become. Therefore it is unlikely that anyone who only treats veins once a week will ever be able to work to the levels demanded by The Whiteley Protocol®.