Print this pageImpact of Creating a Specialty Vein Clinic within an Academic Vascular Practice
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Marc A. Passman, M.D., Jeffery B. Dattilo, M.D., Raul J. Guzman, M.D., Thomas C. Naslund, M.D..
Vanderbilt University Medical Center, Nashville, TN, USA.
OBJECTIVES: There has been a recent trend towards the establishment of specialty vein clinics in an effort to provide more coordinated venous treatment and expand clinical volume for traditional vascular surgical practices. The purpose of this study is to evaluate the impact of creating a new specialty vein clinic within an academic-based vascular practice on clinical volume, physician work load, and financial parameters.
METHODS: All patients evaluated and treated for vein related problems within an academic vascular surgery practice were identified from the institutional billing database using ICD-9 and CPT code queries. Data was stratified according to the time period prior to establishing a vein clinic [PRE-VC] (1999-2001) and after creation of a vein clinic [POST-VC] (2002-2004). Clinical volume, physician work load and financial parameters were evaluated. Comparisons were made between vein (VEIN) and overall vascular (VASC) practice trends.
RESULTS: Comparison of clinical volume, physician workload and financial parameters in both the clinic and operative settings showed larger and more rapid expansion of the VEIN practice than VASC practice between PRE-VC and POST-VC time periods (VEIN vs.VASC growth respectively: new patient clinic volume +262% vs. +118%; clinic relative value units (RVUs) +231% vs. +101%, clinic revenue +301% vs. +144%; procedure volume +448% vs. +119%; procedure RVUs +229% vs. +111%; procedure revenue +193% vs. +110%). Comparison of total VEIN and VASC RVUs during the study period is shown in the following figure: 
Comparing the beginning of PRE-VC to the end of POST-VC time periods, an increasing trend was also present for the percentage of VEIN practice accounting for the total VASC practice (%VEIN PRE-VC to POST-VC respectively: new patient clinic volume 11.6% to 30.2%; clinic RVUs 3.2% to 48.2%; clinic revenue17.6% to 31.2%; procedure volume 3.1% to 14.3%; procedure RVUs 2.8% to 9.8%; procedure revenue 3.3% to 11.7%).
CONCLUSION: Establishing a specialty vein clinic within an academic vascular practice can lead to a rapid expansion of clinical volume with associated increase in physician work load and reimbursement at a rate greater than that for the overall vascular practice. In addition to improved efficiency of care for venous problems, a specialty vein clinic also provides additional sources of revenue for an academic vascular practice especially during times of decreased reimbursement for non-venous vascular work.