As a physician specializing in the management and treatment of venous disease for the past 21 years, and as a leader in the American College of Phlebology, I have witnessed significant changes in how care is provided to patients living with chronic venous disease and, more specifically, venous ulcers. Over the years, we have seen the advent of the dedicated advanced wound care clinic in parallel to the development and expansion of venous and lymphatic medicine specialists. The wound clinics have provided patients with better access to wound care by offering dedicated healthcare providers who specialize in wound management. This specialized care has resulted in the healing of a majority of venous ulcer patients where proper compression therapy and wound management are sufficient. The advancement of the venous and lymphatic specialists and the variety of new treatment modalities for underlying venous disease have also led to greater access to treatment and care for these patients. We (the American Board of Venous and Lymphatic Medicine) now have nearly 800 certified diplomates in venous and lymphatic medicine across the United States who have access to the most current treatment strategies for venous ulcers. As a result of this growth and expansion, we now have strong evidence that proves treating the underlying venous disease will not only lead to quicker healing of venous ulcers, but will also help to delay the recurrence of ulcers in many patients.
As I see it, the key to improving the outcomes for patients who are living with venous ulcerations is to marry the dedicated care of those providers in the outpatient wound clinics with the knowledge and experience of the venous and lymphatic specialists. While I am aware of numerous places across the country where these two paths have successfully crossed, whereby venous ulcer patients are able to receive the most recent treatments and care for their wounds, as well as the underlying venous disease, there still remains a significant opportunity to bring these specialties closer together.
In the current environment of arbitrary coverage policies, shrinking payments, and increasing governmental regulation, we often find it difficult to develop a collaborative approach to patient care, as we are looking to “survive” financially. But if we are going to consistently provide our patients with the best outcomes and improved quality of life, we need to learn to work more closely together on a grand scale. Hopefully, the information you find in this edition of Today’s Wound Clinic will help to expand your understanding that the best approach to treating and caring for chronic wounds associated with chronic venous disease includes seeking out a local venous disease specialist so that, together, all of the clinicians involved can determine which treatments and services should be provided to competently care for the wounds, as well as the underlying venous disease.
K. L. Todd is regional medical director at the Center for Vein Restoration, Dothan, AL.