Dr. Julianne Stoughton Discusses the Rethink Varicose Veins Campaign: Why it Affects Both Patients and Physicians

Q: Tell me about the Rethink Varicose Veins campaign and how it began.

A: As a medical community, we decided that there were unmet needs both in the patient population and physician population for education and awareness of what venous disease is, how to prevent it, and how to treat it. We now have so much less-invasive technology that allows us to treat it at an earlier stage. Up until recently, physicians waited to treat patients until the circumstances were very progressive and advanced. We are aware that this is a progressive issue and that varicose veins are often associated with progression to venous ulcers, skin changes, leg swelling, and lifestyle changes. We wanted to make it publicly aware that there were things that could be done.

There are essentially 3 organizations involved (Society of Vascular Surgeons, American College of Phlebology, and American Venous Forum). Most venous practitioners are in these 3 organizations and we’ve gotten together to help contribute to this campaign so that we can help the whole public. We are, as a group, trying to make patients and physicians more aware that referral to a vein specialist is a good idea early on.

Q: Why is it so important to educate physicians and patients about varicose veins now?

A: In my personal practice in the last decade, I have noticed that many primary care physicians, obstetricians, gynecologists, and others who see people with venous disease have watched and not really treated these patients early on with conservative measures. They haven’t referred them until they have clots in their legs or ulcers on their skin and I always thought, “I wish they would have known.” I’ve tried to go out and give talks in the community, trying to reach out to my colleagues, but this is really an international concern that exploded because treatments have become better. Patients who had surgery many years ago want to know why they have more veins. They weren’t educated properly and feel that treatment failed and they’re never going back again. I feel as though it’s important for these patients to know that there are less-invasive treatments available rather than the old-fashioned surgical procedures.

Q: During the campaign, what educational resources will be provided for health-care professionals?

A: Mainly, it starts out with the website, www.rethinkvaricoseveins.com. There are multiple resources for both segments of the population. For the specialists, there is a lot of information to help them communicate with patients about what varicose veins are, what chronic venous insufficiency is, how to prevent it, and all of the conservative measures. There is also information about how to educate the patient. There are e-flyers, a kit with advertising and banner ads, Facebook and Twitter pages, and resource materials and educational material for medical professionals. There’s also a lot of that same kind of thing for the patient. It also includes self-assessment tools for the patients where they are asked to identify various risk factors in their own situation and some of the symptoms and signs. They can then bring the self-screening to a venous specialist.

Q: Will there be a listing of venous professionals on the website for patients to access?

A: Yes, actually, that is one of the tools for the specialists. They are allowed to have themselves listed. It is something that we’ll screen to make sure the person is legitimate but they will be listed in a group of professionals that are qualified to treat venous disease, which will be available to the public.

Q: Are you holding any screening or treatment events to promote the need for varicose vein awareness?

A:  We have had an American Venous Forum screening program in place for a long time and it has reached a national level. There are many physicians, both in the American Venous Forum and the American College of Phlebology, who have been doing screenings. We are attempting to have a resurgence of those programs and perhaps stimulate more screenings in the community. The more patients are aware, the more they will be looking for those screening programs.  

Q: Are the physicians involved on a voluntary basis?

A:  Yes, I am certainly. There are many volunteers and we’re all involved in trying to get these educational materials and the website going. This is primarily for the better treatment of the patients and education of health-care professionals. We’re basically doing this in our spare time.

Q: How can our audience of professionals in the peripheral interventional field get involved in the campaign on a voluntary basis?

A: The best way to start would be to get onto the website, which has many of those resources that I mentioned. If they wanted to be listed as specialists, there’s one way to do that. If they wanted to have materials or resources for their patients, they can also do that.

Q: Is there anything else that you would like to add?

A: This field has really been exponentially growing in the last decade and we are getting to the point where we have some fantastic tools. There is a little room for improvement but it really has exploded. The next approach is to get more people involved in understanding when these treatments should and should not be applied and trying to prevent this disease. We know that it’s a progressive hereditary problem and I think we need to get some ongoing research as to how we prevent it. The major push here is getting people to understand the idea that this is like a garden. It needs to be tended and it’s not something that’s horrible to treat. It helps to keep the garden healthy and keeps the bad weeds from taking over. Treatment prevents the end stages in the skin and blood clots that patients don’t want to see in older years.

Dr. Julianne Stoughton is an instructor at Harvard Medical School and runs the Vein Center at Massachusetts General Hospital in Boston. She also works in her private VeinSolutions office. Dr. Stoughton attended Dartmouth and Brown University Medical Schools, and completed her general surgery residency and vascular surgery fellowship at the University of Rochester.