American Venous Forum membership: Who are We and Where are We Going?

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The American Venous Forum (AVF) membership was surveyed regarding their current certification and professional activities. The certification survey was forwarded to all of the members of the AVF with a 28% response rate. Of the respondents, currently one-third have a practice limited to venous disease and two-thirds have a mixed practice. Ninety-one percent have hospital privileges that are active, and 9% do not have hospital privileges. Fifty-two percent of respondents have active privileges in an outpatient surgery center, and 48% do not participate in an outpatient surgery center. Twenty percent have a practice limited to office procedures, and 80% have a mixed practice. Sixty-five percent of the membership is board certified in vascular surgery. Several other boards are represented amongst the membership, for example: general surgery, cardiothoracic, and family practice. Respondents identified issues with hospital emergency department call coverage, endovascular privileges, or described their practice as established before vascular board certification. Emergency department call requirements appear to have regional variations with a variety of requirements for hospital privileges. Several respondents plan to limit their scope of practice to venous disease only. Many respondents identified the circular logic of the need for hospital privileges to maintain certification. Many respondents also identified the requirement for a minimum number of procedures to maintain hospital privileges while their scope of practice is still limited. This was especially problematic for arterial procedures in a practice limited to venous disease. As venous stenting, mechanical thrombectomy and thrombolytic therapies evolve, the scope of venous practice will become more diversified. The need for hospital privileges is a current requirement of the Board of Surgery for maintenance of certification. Many members of the AFV have identified these issues as an impediment to board certification. Several respondents, however, identified vascular certification as a bad idea. Modular maintenance of certification was also thought to be a poor solution by some of the membership. Several members suggested a separate standard be applied to those specializing solely in venous disease. The American Board of Surgery will need to address the current requirements as maintenance of certification moves forward. The results of this survey have been shared with the American Board of Surgery.