OEIS Response to Recent Media Articles Regarding Outpatient Vascular Care

July 24, 2023

The Outpatient Endovascular & Interventional Society (OEIS) was formed in 2013 to bring together like-minded physicians dedicated to high quality patient care in the outpatient site of service. By intent and design, OEIS is a multispecialty/multidisciplinary society that was formed around 5 pillars: to establish safety & quality standards, outcome measures, educational opportunities, & appropriate use criteria, while maintaining fiscal responsibility for procedures performed in office-based interventional centers. Our commitment is to the highest ethical standards placing the patient first in our decision-making. These five pillars aim to help foster innovative healthcare delivery in our field, protecting & respecting patient’s decisions about how, where, when to receive their healthcare (protecting the patient-physician relationship) and promoting improved & efficient care coordination & communication among healthcare providers. Specialists from interventional cardiology, interventional radiology, vascular surgery, podiatry, and vascular medicine are represented. Many of these OEIS members have a focused interest in peripheral artery disease (PAD) and critical limb ischemia/chronic limb-threatening ischemia (CLI/CLTI).

The overall impact of CLI/CLTI on life and limb is well known. Amputation is a life-altering result for some patients with CLI/CLTI and certainly an undesired and emotionally taxing outcome for the physicians who take care of them. Unfortunately, the reality is that this aggressive disease may still progress and not all limbs can be saved despite the persistent and often heroic efforts of their physician(s). Eye-catching headlines and tragic, but one-sided stories regrettably do not tell the whole story of the CLI/CLTI epidemic and omit the vast, overwhelming majority of patients who successfully undergo limb salvage/preservation. OEIS believes the better story is one that educates the public about the underlying problem of PAD in general and about CLI/CLTI specifically. The better story is one that discusses the issue of lack of access to expert vascular care for many patients with PAD/CLI. The better story is one that acknowledges the loss and tragedy of an amputation, but also recognizes the win and gratification of a limb saved.

Patients with CLI/CLTI are the most challenging patients whom vascular specialists treat. They put their faith in physicians who persist and give it their best. Physicians from many specialties are interested in improving outcomes and saving patient legs and lives. Possibilities arise through the efforts of passionate physicians who pioneer ideas, techniques, and alternative sites of service to provide outstanding care. Enthusiastic support with education, engineering, research and development from medical device companies has resulted in tremendous gain in helping patients with this devastating disease. While the physician-industry relationship has sometimes been controversial, striking a tone that these collaborations are for pure financial gain is incomplete, misleading, and disingenuous. OEIS believes that patient success involves aligning these efforts, rather than falsely accusing them as something inherently fraudulent or illegal.

A possible response to an “above-the-fold” article is to weaponize it for specific gain. Another is to use it as a vehicle for virtue signaling. Perhaps another is to redirect the reader’s attention to a different issue. OEIS believes it is inappropriate for any group of practitioners to set itself above others that contribute to a particular field of medicine and manage similar patients. Thinly-veiled comments on degrees of training and education and “role-playing” of other specialists is a tired argument. Diseases are not to be owned. More importantly, patients are not to be owned.

The overwhelming majority of OEIS members are board-certified in their specialty and practice evidence-based vascular care and practice with integrity. OEIS believes the better response is to point out the missed opportunity to provide the “rest of the story” in a complete and balanced way, i.e. the success stories and the advancements in the vascular world resulting in better outcomes over the last several years. It has been shown that office-based labs (OBLs) can provide safe, efficient, cost-effective delivery of vascular services with high physician and patient satisfaction, and absent the typical inefficiencies of a hospital. OEIS believes the better response is to acknowledge that there are sites of service outside the hospital providing outstanding vascular care and without these, there would be further limitations in patient access. OEIS believes that true advocacy for patients and for our profession includes acknowledgement that a united front is required in dealing with health care economic, legal, & regulatory bodies. Finally, OEIS believes the better response is one that, despite differences of opinion, communicates a public position of collegiality.

OEIS is comprised of physicians who are dedicated to patient-centered, quality care and who are concerned about appropriateness, safety, and long-term outcomes. The leadership of OEIS fosters close partnerships and collaborative relationships with many established medical societies and specialists to work toward common educational, strategic, and advocacy goals. OEIS operates with cooperation not competition, and with inclusivity, not exclusivity, because we believe it is ultimately in the best interest of our patients to do so.

Sincerely,

OEIS Executive Committee:

Bob Tahara MD FSVS, FACS, DFOEIS, RVT, RPVI

President, OEIS

Gerald A. Niedzwiecki, MD, FSIR, DFOEIS

Co-founder & Past President, OEIS

Bret N. Wiechmann, MD, FSIR, FAHA, FSCVM, DFOEIS

Co-founder & Past President, OEIS

Sam Ahn MD, DFSVS, FACS, DFOEIS

Co-founder & Past President, OEIS