Bringing Vein Care to Rural California

 

Sonora, California. It's located in central California, in the foothills of the Sierra Nevada Mountains with a population of fewer than 4,500 residents. The closest city, Modesto, is about 50 miles and an hour and 20 minute drive, while Sacramento is more than 95 miles away. Here in the heart of California's "Gold Country," Dr. Stephen Hopkins has been developing a successful vein practice offering cutting-edge technology to his patients.

A Board certified general surgeon, Dr. Hopkins has been practicing general surgery since 1995, and practicing in Sonora since 2000. As a solo practitioner in a small town, Dr. Hopkins has been a "jack of all surgical trades" - handling everything from gall bladder procedures to colonoscopies (for which he estimates doing more than 600-700 per year).

VEIN Magazine caught up with Dr. Hopkins to learn more about his emerging vein practice, Sonora Vein Center, to learn why he expanded his practice and to glean some tips on how to successfully grow and diversify a practice and patient base in a rural community.

When & why did you open Sonora Vein Center?

Before I opened my center in 2008, there were no options in Sonora for patients who wanted treatment for vein conditions. Nobody even wanted to offer it in our community. A decade ago, I offered vein stripping and did find vein care attractive, but never pursued it at the time.Basically, I was referring out all patients who could benefit from radio frequency ablation procedures. Back then, the nearest vein practice was in Modesto, about an hour and 20 minutes away.

I had another motivating force as well. Frankly, our area hospital brought in a gastroenenterologist, and I could see some of my GI procedure volume starting to slip. This definitely motivated me to look at ways to expand my practice and for me, vein care was an obvious choice.

Is your vein practice a large part of your overall practice? Can you give us a sense of how many vein patients you see/treat on a weekly basis?

Before I purchased the endovenous radiofrequency ablation technology and began offering these procedures in 2008, my practice was close to 50% endoscopy and 50% general surgery. Today, about 50% of my practice is vein care, and I probably have anywhere from 7-14 new vein patients per week. About half require radiofrequency ablation, and the other half needs sclerotherapy or Veinwave for tiny spider veins.

What treatments/technologies do you offer in your vein practice?

When I made the decision to open Sonora Vein Center, I wanted to offer the whole spectrum of vein care to this community. For me, that meant offering a radiofrequency ablation procedure and sclerotherapy. I have also added in the Veinwave technology for treating tiny spider veins, and now believe I can provide treatment to any patients in my area who need some type of treatment for their veins.

To do this, I had to make to a capital investment. First,in the VN US Closure device as well as purchasing upgraded ultrasound equipment that included a vascular package. My wife is an RN and was trained to administer sclerotherapy.As of July of this year, I also purchased the Veinwave technology and my wife & I have both been trained on its use and application for treatment of small spider veins. Recently,with my vein practice getting busier and busier, I have decided to add some staff, and currently am bringing in a physician assistant as well.

You mention that you've added Veinwave to your service offerings for the treatment of spider veins. My understanding is that this technology was only recently FDA approved (June 2009) and didn't officially launch the product until November. How did you find Veinwave so early on in their U.S. introduction?

My wife, an RN, was introduced first to Veinwave at a weekend course in Chicago where she was taking a handson training course in sclerotherapy. Here, the equipment was being demonstrated by a company representative. His demonstration was very impressive: for small spider veins treated with the technology, the results were immediate -and no bleeding or significant side effects were present. My wife became so enthusiastic after watching these presentations - she called me to look into buying the equipment and was a major influencer in my purchase decision.

Your practice has clearly been an "early adopter" of Veinwave. With a relatively new vein center, what made you be one of the first to jump on board?

When I made the decision to move forward with a vein practice, I knew that my success was more about having great results than just owning the latest technology. The results were impressive, but I wanted to get properly trained and found little opportunity here in the U.S. I decided that to give my patients great results I wanted the best training: I talked to the company, and then decided to spend time with the developer of Veinwave, Dr. Brian Newman in Manchester, UK.

What has been your experience with Veinwave in terms of patient results? Are there any side effects?

Veinwave is great for tiny spider veins. A rule of thumb for treating small veins is that if you can get the bevel of a needle into the vein - you should.-and for these veins, sclerotherapy is the more appropriate treatment. If you can't - for tiny veins that are usually less than 3mm, Veinwave is a great tool. From my experience, no other treatment does what Veinwave does for these small, bright red veins for the face and legs. Tiny little facial veins just disappear. The wow factor is undeniable. As for any after effects - there can be a little redness on legs afterwards that can last for a few hours. Also, there is the potential for what are called microcrusts on the legs, which are tiny scabs where the vein was treated. Interestingly, none of these after effects occur on the face, where there is no inflammation and the results are immediate. It's very effective - no burns or scarring at all.

From my perspective, this is the new gold standard for treating spider veins. While I admit that I have no experience with transcutaneous lasers for treating these veins, I've read the literature and the results are inconsistent. With Veinwave, you treat the veins and the veins close. It's noninvasive, using thermocoagulation to achieve these results. Basically, there is no down time for the patients, and no need for stockings. This is what patients want: to have their veins treated, walk out and be done.

You have built a substantial vein practice in an area that is relatively rural. Are there any additional insights you'd like to offer VEIN readers regarding the key strategies that have helped you grow your practice?

The key to successfully using any new treatment and getting referrals is GETTING GREAT RESULTS for the patients. To accomplish that, I have focused on a couple of things:

- Don't try to limit the services you provide. I'm in a rural area and that's always been a key to my practice success - and also why I have chosen to practice in this type of community. I like being able to offer a wide range of services.
- Make sure you get trained on any new equipment or technology you purchase so that you get excellent results. We get about half of our referrals from other patients. That type of referral only comes from providing excellent results.*
- Assure a nice aesthetic in the office
- Hire and retain excellent employees. This is another key to my practice. I have very low turnover. That means that patients know the staff and are comfortable with coming back to my office time and again.
- For outside marketing, I've found that "Lunch & Learns" work the best here. I update area physicians regarding vein disease and the various treatment options. I've found this to be the most durable source of physician referrals over the year.

In closing, can you share with us your vision for Sonora Vein Center five years from now - in terms of patient base, services offered, and your practice overall?

I know that if I want to treat more patients with venous disease, I'm going to have to do less of something else. I do want to keep my practice in both areas - general surgery and veins but probably increase the proportion of vein care. I definitely don't want to give up general surgery, which is why I'm now recruiting for more staff. In five years, maybe I also will bring on a physician partner.

Clearly, Dr. Hopkins is focused on growing his vein practice and has taken a classic marketing approach to finding a niche, or unique need, in his rural community and then systematically meeting that need by offering a full spectrum of vein care services. Likewise, his single-minded focus on providing great results should continue to help build word-of-mouth referrals for his practice. He's also building broader visibility beyond his rural Sonora community, with a television appearance on Good Day Sacramento in late December where he successfully treated a patient's facial veins with Veinwave. With this type of regional publicity, his vein center is assuredly on a path for continued growth.

For more information about Dr. Hopkins and his practice, go to www.sonoraveincenter.com.

Editor's Note: While Stephen Hopkins, M.D. and his wife, Anne Hopkins, RN are compensated for site-visits to train other practices on the Veinwave technology, they are not in any financial arrangement with Veinwave USA.

About VeinWAVE
Developed by Dr. Brian Newman, a Manchester, UK based surgeon who specialized in the removal of thread veins, Veinwave was introduced in Europe in 2001. Veinwave received FDA approval in June 2009 and was officially launched in November at the American College of Phlebology meeting. The technique uses thermo-coagulation to "microwave" tiny spider veins typically less than .3mm, known as telangiectasia which are too small to be injected with sclerosing agents. With Veinwave, an ultra-thin needle emits a microwave current in the problem area. The heat produced causesthe veins to stick together, stopping the blood flow which causes the veins to be visible. According to company literature, the treatment results in the instant disappearance of the vein. Patients can also resume activity immediately after the treatment with no down time. Side effects such as redness and inflammation are noted to be minimal as well.

For more information about Veinwave, visit
www.veinwave.com or call Veinwave
on 1-888-902-7876

This article appeared in VEIN MAGAZINE WINTER 2010

 

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