Why I do it. A Surgeon´s Thoughts on the Treatment of Venous Disorders, Vein Doctors & Vein Centers

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I was asked by Dr. Duane Randleman to write an article for the Best Vein Care website. This was obviously a great honor and compliment. As I considered what topic I would like to discuss, I realized first that I did not want to focus on the technical aspects of contemporary vein therapy or the underlying pathophysiology. There are numerous sites, including BVC, where patients and physicians can go to further their understanding of the modern management of venous disorders. No, I decided I wanted to discuss something that is perhaps a bit more esoteric but even more important. I decided that I would discuss "why I do it". That is to say, why I have chosen to focus my surgical practice on vein problems.

Frankly, I do it because I love it. That may seem a very simple answer and perhaps a bit cliché; nevertheless it is the truth. I think it is important for patients to understand how their physicians feel about taking care of them. Surgeons spend many years training, to climb a long and steep ladder that can be ascended by only the brightest and technically capable physicians. After many years of hard work one completes a grueling course and is then ready to begin practicing his or her profession. This is a great accomplishment but also a great responsibility. Caring for people is a tremendous privilege that we as physicians take very seriously. Like in any profession over the course of a career, one finds that there are certain aspects of their job that are more satisfying than others. For me, nothing has given me more joy than treating people with vein disease.

I love working in the office setting and building strong ties with my patients. Many of them have been misdiagnosed or given improper or incomplete treatment elsewhere in the past. They are thrilled to finally be in a center that offers extensive expertise in this particular area. Venous disease has been dismissed by so many for so long as cosmetic or inconsequential. It is wonderful to see the relief and appreciation on a patient´s face and hear the gratitude in their voices when they realize that they have finally come to a doctor who not only cares, but also can help. This makes for a very close bond that I rarely saw when doing cardiovascular surgery. In that field the real patient doctor relationship is built between the cardiologist and patient, not the surgeon. I am still amazed how many patients can´t remember the name of the person who performed their quadruple bypass. But in retrospect it is no wonder, as the encounter is often brief and impersonal with little long term follow up.

Maybe this is why I get such satisfaction from seeing my vein patients back in the office. They go on about how much better they feel physically and emotionally and how appreciative they are. It feels great! As a doctor one loves to feel one has made a difference and has made a real impact on the quality of someone´s life. The process is indeed satisfying. It begins with the initial consultation in the office, really listening to the patient´s complaints, perhaps for the first time in their life, and making a correct diagnosis through examination and ultrasound. Later, treatment of the problem follows of course. And, finally exclusively I also direct the post-treatment phase. It is comprehensive patient care that allows me to utilize all of my skills as a physician. I no longer feel like a "technician" or "mechanic" who comes in, in the middle of a clinical situation, fixes a problem and disappears into the shadows.

So, that´s why I do it. I do it because I love it. It makes me happy making my patients well. And, having attended international vein meetings across the country, I know that I´m not alone. Unlike when I attend conferences for cardiothoracic surgery, at the vein conventions I meet excited, energized, enthusiastic men and women who love to get up in the morning and go to work every day. And, that´s the way it should be. Medicine remains a noble profession, despite what some politicians or insurance carriers may say. And, at the profession´s core remains the unique and wonderfully rewarding human relationship between doctor and patient. We do it because we choose to do it, not because we have to do it. We do it because we love it!

John A. Chuback, M.D., FACS, FCCP, FICS

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