Really Shocking Facts About Varicose Vein Treatment in Pittsburgh

Really Shocking Facts About Varicose Vein Treatment in Pittsburgh

Need to Know Facts About Varicose Vein Treatments in Pittsburgh

I promise that what you read in this article really will shock you – or it should – about varicose vein treatment in Pittsburgh. What you are about to read will deliver on that promise. This information will be quite valuable to you.

It will help make you an informed consumer who can successfully walk through the minefields that are varicose vein treatment centers in Pittsburgh.

The purpose of this article is to cover in a few minutes what you need to know about varicose vein treatments.

In military or political terms this information would be termed “Classified” or “Need to Know”. It is similar to secret information that governments allow leaders to make informed decisions.

What You Really Need to Know About Varicose Vein Treatments

At a recent vein conference this year, the course director who is also a leader in the field of venous disease polled the audience of vein doctors. He asked if there was anyone in the room of over 700 doctors who had not seen in their home town the unnecessary treatment of normal saphenous veins.

Not one doctor in the room raised their hand.

It’s rampant.

I’m not making this up.

I have seen and experienced it over and over.

It’s not just a few rotten apples in the barrel.

And it’s not just the outlier vein centers in the city of Pittsburgh.

Here are some comments by other vein physicians about these unnecessary procedures.

The following article warned vein doctors not to incentivize the sonographer to show reflux when a vein is normal. This important article is a list of “don’ts” addressed to remedy the problem.

To try to curb the overutilization of vein treatments, some doctors have suggested vein physicians take a pledge which condemns these practices of exploitation as a solution. The Hippocratic Oath is a pledge that all physicians recite on graduation day.

I have personally witnessed this nearly every week from people coming to see me for a second opinion. These patients sensed that the recommended treatment at another vein center was overly aggressive and costly. They sensed that something wasn’t right about the other place. Perhaps, the fact that they never saw a doctor tipped them off.

Since everyone has at least four saphenous veins in both of their legs, many people who come to me for a second opinion were told that they were told by another vein center that they needed all four of their saphenous veins removed or burned.

It’s rampant in the city of Pittsburgh from what I have personally seen. It is also a nationwide problem from what I have read and heard at medical conferences from other vein doctors.

It seems that many vein treatment centers have lost their moral compass. It’s not a slip of judgement to recommend these unnecessary treatments.

  1. It’s deliberate.
  2. It’s methodical.
  3. It’s premeditated.
  4. It’s patient abuse.

How Does This Unlawful Activity Occur Behind the Scenes?

The biggest hurdle for insurance reimbursement for illegal and unnecessary varicose vein treatment is for the ultrasound test that is done on the saphenous vein. It needs to be falsified to treat normal veins unnecessarily.

The vein center’s financial success will be greatly enhanced if all four saphenous veins are shown to be abnormal when in actuality they are normal.

Ultrasound Doppler vein tests are done in house. That means all that the vein center has to do is convince the vascular ultrasound technician whom they employ to find a problem where there is no problem.

The technician is well aware that the vein center’s profitability depends on the test being abnormal. The more abnormal tests, the more procedures that can be performed.

At a recent vein conference, a vein doctor told the audience of vein doctors about vascular ultrasound technicians who travel to vein centers and deliberately falsify test results to make them appear abnormal when they were actually normal.

The abnormality that is necessary to justify getting rid of the saphenous vein is called reflux. That means that the test must show blood backing up in the wrong direction lasting for over one half second while the patient is standing up.

The patient must also have symptoms. Many people will make up vague symptoms even if they have none. When pressed, most people have some degree of leg symptoms.

Most insurance companies require that these symptoms must interfere with the activities of daily living before they will be covered by insurance. That is the second area of fudging the truth by a fraudulent vein center.

Outrageous Varicose Vein Treatment Facility Costs

Happel Laser & Vein Centre is an independent medical practice. That means that a hospital has not bought our varicose vein practice.

When you have your procedures done in our IAC accredited vein office, there is never a facility fee for you or your insurance company.

At vein practices that have been bought by a hospital, you will also be charged an incredibly expensive facility fee.

Would you rather have a bill of $2,500 or less (with us) or up to $10,000 (with these expensive overpriced hospital outpatient facilities that aren’t even accredited).

That’s because a hospital bills the physician component separately from the facility component.

Hospitals’ outpatient facility component is much higher than insurance companies allow for independent doctor’s offices (where it’s free)!

The Happel Laser & Vein Centre remains independent so there are no high-priced additional facility fees on your final bill.

At Happel Laser & Vein Center, you save lots of money by having your procedure done at the only accredited vein center in Pittsburgh.

Vein Treatment Reimbursement

This country’s health system reimbursement is based on procedure volume rather than cognitive skills.

That is why interventional cardiologists who do stents and orthopedic surgeons who perform surgical operations are paid much more than other specialties which cannot bill for procedures.

The more varicose vein treatment procedures that are done, the more money the vein center and the vein doctor can make.

Higher volume equals higher pay.

That’s how it works in a nutshell.

Like many other things in life, it comes down to money.

Medical students are in debt up to half a million dollars when they finish their training and have sacrificed their youth studying and training. They are mission driven and are committed to helping people.

Most doctors are ethical and moral.

However, varicose vein treatments are done in an office setting where there is no peer review. No one at all is looking over their shoulder. Varicose vein treatments done in Pittsburgh have raised a great many questions in this regard.

How to Protect Yourself from Unnecessary Varicose Vein Treatments

Be skeptical.

Research the indications for any recommended procedure. If any doubt remains, seek a second opinion from an independent physician with experience, superior ultrasound Doppler skills, and integrity. Avoid volume driven franchised vein centers with multiple satellite offices.

Ask to be shown the reflux in the vein when the technician is performing the Doppler ultrasound test.

You can check to see if the vascular Doppler ultrasound test is abnormal yourself.

As you are standing, look to see how long the vein turns red after the technician squeezes the veins.

If the red color lasts longer than half of a second, you have an abnormal refluxing saphenous vein.

Since reimbursement is tied to procedures, ask the vein doctor who employs them. Is there a potential conflict of interest? Do you feel comfortable?

Do not submit to a vascular ultrasound Doppler test if you only have spider veins. The saphenous veins are almost always normal if you have only spider veins.

Most vein centers in Pittsburgh will recommend a vascular Doppler test performed by a vascular ultrasound technician.

Refuse the test if you only have spider veins!


It is unnecessary. The test will make the vein center around $250. The test will almost always be normal. Many vein centers in Pittsburgh are guilty of this.

Do not let a vein center laser or use radiofrequency ultrasound to close off and permanently remove your saphenous vein if you only have spider veins. You may need your saphenous veins someday for heart bypass.

Dr. Peter Lawrence MD, past president of the Society for Vascular Surgery discussed this in his presidential address. Dr. Ralph Samson MD, a vascular surgeon, wrote about saving the saphenous veins in this article about saving our saphenous veins from unnecessary surgery.

Ron Bush MD, a vascular surgeon and vein expert, called the field of treating veins a “quack magnet.”

Varicose Vein Doctors and the Hippocratic Oath

Doctors are bound by a code of conduct called the Hippocratic Oath.

All doctors recite the oath when we graduate from medical school.

The most important principle in the Hippocratic Oath is – First do no harm.

Physicians during the Third Reich in Germany did not recite the Hippocratic Oath but apparently knew of the ethic of “nil nocere” – do no harm.

Wouldn’t permanently removing and destroying the leg veins required for a heart bypass for profit be as unconscionable as Nazi war crimes?

Ethical infractions like performing unnecessary laser or burning the saphenous veins with radiofrequency unnecessarily is quite common.

It has resulted in letters to primary care doctors and medical boards stating the obvious problem.

The Pennsylvania state medical society is aware of these abuses.

The Intersocietal Accreditation Commission which is in charge of vein center accreditation is aware of the problem.

The commercial insurance companies including Medicare are also aware. All they care about is that there is an over utilization of vein care. Their backlash response is to restrict care in order to decrease their costs. Often that results in denying essential vein care to patients who really need it.

The solution is not so easy.

The problem is that it is extremely difficult to prosecute these cases. The risk of punishment is so remote that it allows the abuses to continue.

Therein lies the rub.

Do not forget the following. The saphenous veins are the ones that heart surgeons use and need in case you ever require a heart bypass! Vascular surgeons also need the saphenous veins to perform leg bypasses for blocked leg arteries to save your leg.

Varicose Vein Centers and the Golden Rule

“Do unto others” is the classic guideline.

How did varicose vein physicians and in turn the vein centers that they either run or work for become so confused?

How did they lose their conscience?

Once the ethical line to the dark side has been crossed, there is no return. It’s like telling someone who is depressed to get over it. Or like telling someone to stop worrying. That doesn’t happen.

You may have heard of the alternate Golden rule. He who has the gold – rules. Don’t allow unscrupulous vein centers profit at the expense of your health. It’s not just glib advice.

That later transmutation of the Golden rule is why this article was written. It’s to “pay it forward.” It is meant to prevent what has happened to others from happening to you.

For any vein doctors reading this – It’s karma don’t cha know.

Five Things You Didn’t Know About Pittsburgh Varicose Veins Treatment but Should Know

  1. Unscrupulous vein centers in our city are removing normal and important saphenous veins with laser and radiofrequency for profit.
  2. Untrained doctors are performing these procedures.
  3. Opportunistic burned out doctors are entering the vein field to escape the field in which they trained.
  4. Unethical unnecessary vein tests for profit are being falsified. This results in unnecessary vein procedures which are being performed in Pittsburgh at an increasing rate.
  5. We have over utilization and inappropriate use of minimally invasive technology that makes it easy for this to happen in the unregulated office environment where inspections are optional.


Be your own self advocate.

Be Your Own Varicose Vein Patient Advocate

Be wary and suspicious of all recommended vein treatments.

Not tin foil hat suspicious – just aware.

Beware of deceptive marketing like, “95% of veins are covered by insurance”.

If things don’t seem right, don’t hesitate to get a second opinion. Places that will bill cosmetic spider veins to insurance don’t hesitate in breaking the rules. You can be their unwitting accomplice.

If you don’t see a doctor on the day of your consultation, get a second opinion.

Make sure the vein center is accredited and has been inspected to help stop the abuses discussed in this article.

Examine the vein doctor’s credentials and qualifications carefully.

Many vein doctors in Pittsburgh were not trained in vascular disease. They switched to treating varicose veins from other fields. That is not a good sign.

Read reviews of the vein center and doctor whom you choose. Read LinkedIn profiles, YELP, Healthgrades, Vitals and Google reviews to find the best vein doctor in Pittsburgh.

Dr. Happel is a vascular surgeon who is board certified and fellowship trained at the Mayo Clinic. There is no higher qualification in the country for treating varicose veins. He practices only on varicose veins and practices vein medicine full time.

He is also the most experienced (over thirty years) vein specialist for the treatment of varicose veins in Pittsburgh. He practices responsibly and ethically.

Call us at 724-969-0600 to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.