|
BALANCING MEDICINE & LIFE Changes after specialty switch
(Lima News, The (Ohio) (KRT) Via Thomson Dialog NewsEdge) Dec. 30--LIMA -- Dr. Ron Bush made his own specialty.
Bush, a doctor with Midwest Vein Center in Lima, is not only one of the few phlebologists in the world, but one of its pioneers. Some of the research on one of the lasers used in endovenous laser treatment was done in Lima, Bush said.
Bush, 59, was once a vascular thoracic surgeon, coming to Lima in 1984. The specialty in treating vericose veins arose in the last eight years, Bush said.
"Ten years ago when we were practicing in Lima in active surgery, we decided to do more with venous surgery because not much was being done," he said.
Bush had two draws to vein treatments: the excitement of an emerging field of medicine and the chance to leave behind the life of a heart surgeon.
Bush said one aspect of heart surgery he did not like was its repetitiveness. "I really didn't like the lifestyle," he said. "I did pediatric heart surgery for awhile. You were tied to the hospital all the time."
Bush said he quit heart surgery so that he didn't have to be so busy. He said he was also compulsive about his surgery, visiting patients in the middle of the night because he didn't trust anyone else to do it.
Those factors are also drawing other surgeons into phlebology, Bush said. He has trained about 1,000 of them since delving into it.
"It is getting tired of doing what they've been doing for 20 years, night calls, hospital work. When you do vein surgery, you have no real need to go to the hospital, you don't take night call," Bush said.
Bush said existing surgeons are the ones making the switch. The vein techniques are just now being taught in residency, so younger doctors have had little chance to move into the specialty.
Herb Schumm, vice president of medical affairs at St. Rita's Medical Center, said he has seen a limited number of doctors changing specialties -- going back to get additional training.
"I've seen family doctors go back and do residency in obstetrics and (then) went into OB," Schumm said.
Schumm said what he is seeing more often are doctors narrowing the scope of what they provide.
"What we're seeing is people dropping high-risk procedures out of their practice. They still may be doing surgery, but now they're doing a limited segment of surgery," Schumm said.
In some cases, Schumm said, they may also be narrowing the scope of patients they see in order to weed out those who are highrisk. The primary driving force is liability insurance.
"Medicine has a high burnout rate. They can get cynical about it if they don't stay fresh or renewed," Schumm said.
The experience in veins renewed Bush.
"Nobody was doing veins at the time I started and there wasn't much written about it. All you did was strip a vein out, big scars, painful. I figured there must be something better to do," Bush said.
The switch took place over the course of a year, where Bush and others developed techniques to treat veins in the office. At the point where a laser could be used for treatment, Bush was sought to do clinical work for an ultrasound guided laser.
"We did the FDA trials for the 940 laser. There are different wavelengths in lasers. There are four different lasers being used now," Bush explained. "Out of the first 100 patients, most of them were in Lima, most people aren't aware of that."
Bush is doing the FDA trials for a fifth laser out of his Dayton office.
Five years ago, there may have been 1,000 laser ablations performed. In 2006, experts are predicting 500,000.
Bush said there is a huge market for vein procedures, noting that 20 percent of the population has significant vericose vein problems.
"It is the most common abnormality that mankind has," Bush said.
Bush said there could be 30 to 40 million patients out there who could use the vein procedures.
Vein Surgeons for Excellence, headquartered in St. Louis, has doctors who were mostly heart or vascular surgeons before treating veins only. Midwest Vein Center is an affiliate and the company is growing by about 10 clinics per year.
"In my opinion only surgeons should be doing these cases because sometimes you need more than to use a laser," Bush said.
Bush still has a busy life, traveling often for training and to visit some of those clinics. He is the medical director for 22 of them.
"Don't miss aneurysms or lung cancer patients," Bush said. He said his malpractice insurance is a fifth of that of the typical vascular surgeon.
"It is a new field and that is exciting for me. I've done so many publications and papers."
The average case takes 25 minutes, Bush said, opposed to having the veins stripped out in surgery followed by days of being laid up in the hospital.
"There's no need to go to the hospital anymore. It is much safer than surgical procedures," Bush said. All that is needed is a computer, a needle and a catheter. "They don't feel anything."
[ Back To TMCnet.com's Homepage ]
|
Find Solutions for Enterprises, SMBs & Service Providers at the INTERNET TELEPHONY Conference and EXPO West, September 16-18, 2008. Los Angeles, California.
