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Cosmetic surgeon maintains financial balance by adding vein care

Key iconKey Points

  • Venous insufficiency has a heredity component 70 percent of the time
  • Venous insufficiency is reimbursed by health insurance
  • Cosmetic surgeons should dedicate sufficient time to understanding venous disease and treatment options

Adding modern vein care to his cosmetic surgery practice was a synergistic move that helped Colin E. Bailey, M.D., maintain fiscal equilibrium even in the most unsettling economic times, he says.

Dr. Bailey, of Bailey Cosmetic Surgery & Vein Centre, Osage Beach, Mo., says combining venous insufficiency treatment and cosmetic surgery in one practice makes good business sense because the distinctly different initiatives are often on the to-do list of the same group of patients.

"Venous insufficiency is extremely common," Dr. Bailey says. "Forty percent of women in their 40s and 60 percent of women in their 60s have it. The demographics are on our side as far as the overlap with our target market for cosmetic surgery."

Additionally, he says, venous insufficiency has a hereditary component 70 percent of the time. "So every patient that you treat likely has a mother or a sister or a daughter who may be a future patient."

People who are already his cosmetic surgery patients tend to be ideal candidates for venous insufficiency treatment, according to Dr. Bailey.

"If you have a large cosmetic surgery practice, you don't have to go out searching for these patients because they're already there," he says. "If we don't take care of them, they're just going to go somewhere else."

The fact that venous insufficiency is reimbursed by health insurance helps stabilize the practice, Dr. Bailey says. "When the recession was at its worst and out-of-pocket procedures like cosmetic surgery suffered, our practice saw very little change because we had this whole other practice specialty. Offering both out-of-pocket services and the insurance-reimbursed services has helped us build a stable practice."

Dr. Bailey says his practice has a multiple seven-figure revenue stream with 55 percent of that represented by vein treatment and 45 percent by cosmetic surgery. "The cosmetic segment is rapidly growing, in part due to our vein center," he says. The practice had three locations at the time of this interview and was planning an expansion to four centers.

LOOKING AT LOGISTICS Dr. Bailey says he schedules venous insufficiency patients on separate days from cosmetic surgery patients, and in essence runs each like a separate part of his busy practice. Each limb, he says, feeds the other.

"We see a tremendous crossover from one limb of the practice to the other. As a result we spend very little — less than $3,000 monthly — on marketing for cosmetic surgery," he explains.

Dr. Bailey says he uses ultrasound technology to diagnose venous insufficiency; both the diagnosis and treatment are covered by health insurance. "People often think this is just an aesthetic issue, but whenever you see someone with bulging veins, typically thought of as varicose veins, this is actually indicative of venous insufficiency. If these bulging veins go untreated, they continue to become more painful and put the patient at risk for complications," he says.

There may also be a spider vein component, and treatment for spider veins is not covered by health insurance, Dr. Bailey says.

"It is always important to treat the underlying venous insufficiency prior to treating spider veins or the spiders will reoccur with a vengeance," he says.

The best treatment for spider veins of the legs is cosmetic sclerotherapy, Dr. Bailey says. "Surface laser treatment for spider veins is not the gold standard and often results in a poor outcome and a displeased patient."

Ultrasound technology is a tool that has changed the paradigm of venous insufficiency treatment, according to Dr. Bailey. "It enables us to diagnose venous insufficiency in a noninvasive fashion in the office in 45 minutes."

Once diagnosed, there are several modern treatment options from which to choose, he explains.

"Endovenous laser is one of the tools in the toolbox. During this procedure a laser fiber is inserted into the insufficient vein and the vein is heat-sealed. The blood is automatically rerouted into the healthier, deeper veins," he says, adding that radiofrequency is another endovenous option to heat seal veins.

According to literature, the success of laser or radiofrequency for venous insufficiency treatment is between 95 and 97 percent closure rate. "There is a 1 percent or less chance of having a blood clot, also known as deep vein thrombosis," Dr. Bailey says.


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