11, 11, 2021

How We Support Veterans and Military

2021-11-11T08:49:52-08:00

We provide vein care services for all veterans and active military. We provide treatment and diagnosis of varicose veins, chronic venous insufficiency, venous leg ulcers, and deep vein thrombosis.

First off, on this 11th day of November, we honor all who have served and sacrifice. We greatly appreciate our military personnel. Being a military daughter myself, and then working at the VA Healthcare and providing vein care for veteran’s, I continue to be committed to providing vein care services to promote healthy legs for veterans and active military. While military personnel have some of the most fit and healthy legs veteranman-and-woman_web copy

Triwest and VA Champs

La Jolla Vein Care has partnered with Veterans Affairs and Tricare to take care of our veteran’s varicose vein and leg health needs.

amongst all of us, military personnel and even Olympic athletes even can develop vein conditions. Certain occupations are known to increase the risk of developing vein disorders, such as standing occupations. At the VA, I often saw patients who stood guard for many hours on end, or had other risk factors for developing varicose vein disease such as leg trauma, or jumping out of airplanes. The range of vein disease I frequently saw at the VA included chronic venous insufficiency and venous leg ulcers, varicose veins, and venous reflux disease.

Here at La Jolla Vein Care, we accept VA Champs, which allows VA patients to be seen at our clinic and TriCare for active military. If you would like to be seen at our clinic, please contact our Veteran and military new patient coordinator at 858-550-0330 extension 104.

Happy Veteran’s Day.

How We Support Veterans and Military2021-11-11T08:49:52-08:00

18, 9, 2021

New Chula Vista Location Now Open

2021-09-18T17:55:19-07:00

World-class vein care is now available in your own backyard if you live in or near Chula Vista. La Jolla Vein Care has opened a convenient location to serve our San Diego patients who live near Chula Vista, National City, and other cities in the South bay. Our same team, including Dr. Lucas and vascular sonogprahers will go to the Chula Vista location on select days.
The same services as the La Jolla location will be offered including:
Varicose vein treatments, diagnosis and evaluations, physician consultations, ultrasound, and vascular lab services.
*Asclera™ *Endovenous Chemical Ablation *Endovenous Laser Ablation *Foam sclerotherapy *Laser vein ablation *Leg Ulcer treatment *Microphlebectomy *Radiofrequency Ablation *Sclerotherapy *ClariVein® *Spider Vein Treatment *Ultrasound Guided Foam Sclerotherapy *Ultrasound Imaging *Varicose Vein Treatment *Varithena *Vascular Lab Imaging *Venous Ultrasound Imaging
Call now to schedule your appointment at the Chula Vista location: 858-550-0330

New Chula Vista Location Now Open2021-09-18T17:55:19-07:00

7, 6, 2021

How Laser Vein Ablation Works to Treat Varicose Veins

2021-06-07T13:47:35-07:00

The VenaCure EVLT procedure is minimally-invasive and can be performed in a doctor’s office. It addresses both the cosmetic and medical issues associated with varicose veins.

A laser light emitted through a thin fiber inserted into the damaged vein delivers just a small amount of energy, causing the malfunctioning vein to close and seal shut.
Veins that are treatable with the VenaCure EVLT system are superficial veins. Laser therapy with the VenaCure EVLT system is indicated for varicose veins and varicosities with superficial reflux of the Greater Saphenous Vein, and in the treatment of incompetent refluxing veins in the superficial venous system in the lower limb.
After the VenaCure EVLT procedure, your body will naturally route blood flow to other veins.
Bulging and pain in the damaged and now-sealed vein will subside after the procedure.
Because VenaCure EVLT vein treatment eliminates varicose veins where they start, the results can be obvious right away.

Before undergoing any treatment, it is important to discuss with your physician the risks, benefits and alternatives to the procedure.
Complications with vein treatments are rare, but you should be aware of Potential Complications:

Potential complications include, but are not limited to the following: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, skin pigmentation alteration, neovascularization, paresthesia due to thermal damage of adjacent sensory nerves, anesthetic tumescence, non-target irradiation, hemorrhage, necrosis, DEHP exposure, skin burns and pain.

To read more about the VenaCure EVLT procedure that we perform at La Jolla Vein Care, click here. To schedule a consultation or telemedicine visit with one of our physicians to further discuss laser treatment and alternatives to laser, call us at 858-550-0330.

How Laser Vein Ablation Works to Treat Varicose Veins2021-06-07T13:47:35-07:00

1, 5, 2021

How Ultrasound Can Detect Hidden Dangers in Leg Veins

2021-05-01T01:06:15-07:00

The Duplex Ultrasound examination allows us to visualize the blood vessels that are not visible to the naked eye, even blood vessels that are deep within the muscles. Ultrasound looks at deep and superficial veins in the legs to check for venous-valvular incompetence (the underlying condition that causes varicose veins). The ultrasound examination is used to both identify the veins that have faulty valves and to map the anatomy of the veins, creating a ‘road map.’ This is necessary to make an accurate assessment of the cause and extent of the varicose veins, as well as to formulate the best treatment plan. This should be done for any individual being evaluated for varicose veins, leg swelling, skin changes, patients who have failed prior treatment, patients who are symptomatic and in some patients with certain anatomic patterns of spider veins.

Before your test:

This study does not require any preparation. You should not wear your compression stockings the same day as the examination. Make sure to be hydrated.

How Ultrasound Can Detect Hidden Dangers in Leg Veins2021-05-01T01:06:15-07:00

28, 4, 2021

Vein Care’s Dr. Foghi Interviewed in San Diego Voyager

2021-04-28T00:28:48-07:00

We would like to share with you our very own Dr. Armin Foghi’s interview in San Diego Voyager Magazine. Dr. Foghi discusses his career path, obstacles and what makes him happy. This read gives you a personal take on one of San Diego’s best vein specialists- dedicated to the diagnosis and treatment of vein disorders.
You can find the link to the interview here

Vein Care’s Dr. Foghi Interviewed in San Diego Voyager2021-04-28T00:28:48-07:00

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego

2021-04-25T00:47:37-07:00

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego
La Jolla Vein Care is pleased to announce that we’ve recently enrolled with Medi-Cal. This means that more people in San Diego and Southern California have access to world-class vein treatments. Most patients with Medi-Cal can now be seen by our award-winning vein experts, have a diagnostic ultrasound and help with:
-painful varicose veins, that interfere with work and lifestyle
-leg ulcers that do not heal
-leg swelling
-lymphedema
-phlebitis
-leg pain
-superficial thrombophlebitis
-blood clots

Does Medi-Cal pay for varicose vein treatment? Does Medi-Cal pay for leg vein treatments?
There are different types of Medi-Cal health coverage.
If you have Medi-Cal and would like to make an appointment, we recommend to call or text our office. We can take your insurance information and verify if the visit would be covered with your specific plan. Call us at 858-550-0330 or text us at 858-283-4099. You can also find more information about Medi-Cal insurance here.

Medi-Cal Coverage for Varicose Veins and Leg Ulcers in San Diego2021-04-25T00:47:37-07:00

Dr. Bunke interviewed by Modeliste Magazine!

2021-04-11T23:28:39-07:00

 

Tell us about La Jolla Vein Care and what makes it so unique and such a leader in vein treatments.

La Jolla Vein Care is unique because we exclusively specialize in vein disorders. This means we are able to perform all ultrasound diagnostics in-office and offer all treatment options for vein conditions vs.a one-size-fits-all approach based on more limited treatment availability. Since we are skilled in all modern treatment modalities, we can truly customize a treatment plan to the unique needs of the patient. Our leading edge treatments are able to treat most vein conditions, including large varicose veins without surgery, using endovenous techniques.

Read the full interview on our media page
To see the full magazine online

Dr. Bunke interviewed by Modeliste Magazine!2021-04-11T23:28:39-07:00

13, 1, 2021

Dr. Bunke in Authority Magazine

2022-01-04T04:04:50-08:00

From an interview with Candice Georgiadis Candice Georgiadis 

ASa part of my interview series with prominent medical professionals about “How To Grow Your Private Practice” I had the pleasure of interviewing Dr. Nisha Bunke, MD, FAVLS, RPhS.

Dr. Nisha Bunke is a venous disease specialist, who founded La Jolla Vein Care, San Diego’s only accredited vein center in 2010. She was the first physician in the United States to complete fellowship training in this specialty supported by the American Vein and Lymphatic Society and is a diplomate of the American Board of Venous and Lymphatic Medicine. She is also the author of the medical textbook, The Vein Book (Oxford Univ. Press 2013), numerous scientific publications, and CEO of Recova, Inc.

am a venous disease specialist, meaning I treat the entire spectrum of superficial venous disease affecting the legs, including painful varicose veins, leg ulcers and blood clots. This is a niche specialty that has been growing over the past decade because vein conditions are so common. I was the first physician in the United States to complete fellowship training in this specialty, which is supported by the American Vein and Lymphatic Society. Venous disease is pervasive. During the early years of my private practice, I also served as a volunteer clinical instructor at UCSD, where I treated patients at UCSD Medical Center as well as the Veteran’s Affairs Medical Center.

Earlier on, I did not plan on having a private practice. However, while working in university and government medical settings, I saw obstacles that prevented patients from getting fast and convenient access to vein care. I liked the idea of being able to control the patient experience and creating a concierge-style, individualized and patient-centered practice. Being a physician and business owner allows you to exercise both parts of the brain. The medical decision-making, science and data-driven part of the brain is ingrained in any physician, but the business owner side allows one to be creative, making creative decisions from areas ranging from website functionality and design to how to effectively market and grow the practice.

As a provider and business owner, I tried to do everything myself for many years. That is a quick way to experience burn out. For balance, I’ve learned to delegate things that can be delegated. As a physician, I can’t delegate patient care and my judgment, but I can delegate business-related roles, which is why it is valuable to surround yourself with a strong and supportive team. The right team members will make your job a lot easier.

When I’m seeing patients, I’m 100 percent dedicated to patient care, not considering business at all. With a heavy patient load, I used to find myself working on the business itself on the weekends and evenings, until I eventually hired other physicians and nurse practitioners to help with the patient load. This allowed me to have more administrative time, which is important for accomplishing work related to quality of patient care like quality assurance reviews, overseeing our facility accreditation and allowing time to have team meetings, staff training and other marketing and business administration tasks. If you really care about your practice, it makes sense to spend time on things that count — from the quality of care you provide to patients to the attention and training employees receive.

Ultimately, it is the practice owner’s responsibility for the quality of care delivered and upheld within the practice.

The biggest hurdle that is prominent in my mind is the financial hurdles medical practices tend to experience. I think you have to be open-minded that it can take several years to really become established, especially when your business is heavily reliant on word of mouth referrals. There is so much to prove, and it takes patience and, of course, time.

I had to learn it was all simply part of the process. Without failure, there are no learning curves to grow from. One of the most important things a person should keep in mind if they’re hoping to start their own practice is realizing there are going to be failures, just like any other business will experience.

Know your patients. You know your patients and what is in their best interest. Use this knowledge to your benefit and market your business and experience to the audience accordingly. If you have patient reviews and testimonials, for instance, learn from them to improve a future service or to boost your practice’s credibility and reputation. Knowledge is power. Take what you know about your patients and use that to reach future individuals who may not have even been aware they needed your service.

Be involved with the management of your team. Patients tend to compliment my staff often, and they say that employee attitudes trickle down from the top. I agree with this, and I have noticed if customer service is not on par, it usually is tied to the top. If there is a staff member who tends to be a little less friendly, maybe it’s because their boss isn’t too friendly themselves.

Research EMR options. This is a must! There are many different types of electronic medical record (EMR) options, some are specialty-specific. I have seen EMRs that are touted but would not be right for my practice because of my documentation preferences and need to incorporate ultrasound and leg images, or inability to utilize text and email appointment reminders, or lack of billing capabilities. All EMRs are very different. I recommend trying different EMRs out before committing to one.

Consider outsourcing billing. I outsourced billing for the first few years of my practice, which is a cost-efficient option for practices starting out. If you choose to do billing in-house, your billing expert needs to be experienced and detail-oriented.

Consider outsourcing HR. For small practices, it doesn’t make sense to hire a full-time HR professional. Instead, we use a professional employer organization (PEO) company to offer employee benefits, facilitate payroll processing, provide risk management resources, human resource consulting, employee training and more.

Yes, this was huge for me. I never wanted to charge people for my services. Most physicians go into medicine because it is an altruistic profession. At some point you realize that you have a special skill set that most people don’t have and that brings value. And while you want to make things affordable for patients, you will not be able to offer any services if you can’t pay the rent or pay employees. To mitigate this struggle, I have designated personnel to handle invoices and payments from customers.

If possible, I put my work down and start fresh at another time. I’ll choose to go for a walk, exercise when I am able to or pull my senior staff aside to talk or brainstorm ideas. Anything that will give me a mental break for a fresh, focused start.

My mentor was Dr. John Bergan, who I trained under during my fellowship. He was a world-famous vascular surgeon known not only for his academic brilliance, but also for his great bed-side manner. I had the opportunity to work with him at his private practice. I was able to observe his approach, how he treated people and made them feel important — from his staff to patients.

Every day, he had a pearl of wisdom I could learn, especially about giving presentations to other physicians.

He also taught me you can’t make everyone happy all of the time. As a physician, if one patient is upset or leaves a bad review, it can be taken to heart. You need to focus on the fact that you make most patients happy. The same with staff, there’s always someone who’s going to complain. You can’t make everyone happy all of the time.

I relied a lot on interfacing earlier on, from conferences and face-to-face instructional dinners to webinars educating physicians on what it is we do. It was a way to get to know people on a personal level, while also giving them a taste of your extensive knowledge and experience in the industry.

I can’t remember specifically any very bad advice. I can tell you that everything has been trial and error, so some people give you suggestions and you have to be open and know they might not work for your practice.

The classic, Good to Great: Why Some Companies Make the Leap and Others Don’t. Studying business failures is as important as understanding business successes.

Thank you for these great insights!

WRITTEN BY

Candice Georgiadis

Candice Georgiadis is an active mother of three as well as a designer, founder, social media expert, and philanthropist.

Authority Magazine

Authority Magazine

Leadership Lessons from Authorities in Business, Film, Sports and Tech. Authority Mag is devoted primarily to sharing interesting feature interviews of people who are authorities in their industry. We use interviews to draw out stories that are both empowering and actionable.

Dr. Bunke in Authority Magazine2022-01-04T04:04:50-08:00

28, 6, 2020

3-Stage Approach to Vein Treatment

2020-09-17T17:58:02-07:00

When visible signs of venous disease such as spider veins, varicose veins, or skin changes are present, this is usually the tip of the iceberg, and an underlying vein problem is present. An underlying vein condition (venous reflux disease) can be detected with ultrasound. A treatment plan is focused on treating the underlying vein problems first, then working outwards.

image of an Iceberg as a metaphor for the hidden dangers of vein disease

Iceberg, a metaphor for the hidden dangers of vein disease

How Is Venous Reflux Disease Treated?

Step 1: The Underlying ProblemThe first step is to treat the underlying problem, the venous reflux. The specific pattern of venous reflux was detected by ultrasound. Venous reflux usually starts in the saphenous veins. The saphenous veins are most effectively treated with vein ablation procedures. This involves placing a small catheter within the vein and using heat or a solution to produce injury and eventual closure of the vein. The most commonly used treatments for the saphenous veins are radiofrequency ablation (RFA), laser ablation, mechanico-chemical ablation (MOCA or Clarivein), and in some cases Varithena Foam. The treatment recommendation is customized, based on where reflux is present and other clinical factors.

Step 2: Varicose Veins

After the underlying saphenous vein reflux is corrected, the bulging veins (varicose veins) can be treated by injecting a foamed medication that will cause them to scar and eventually dissolve (foam sclerotherapy), or to remove them using tiny incisions. The most common method is foam sclerotherapy.  This is also known as ultrasound-guided foam sclerotherapy (UGFS).

Step 3: Spider Veins

Spider vein treatment is always considered a cosmetic procedure. If improved cosmesis is a goal of treatment, make sure to discuss this with your doctor and plan on having cosmetic treatment as the last step. Spider vein treatment is accomplished by sclerotherapy, which is an injection of a liquid medication into the spider veins. Most patients use 3 vials, and have an average of 3 treatment sessions.  Ask your provider for an estimate about how many treatment sessions/ vials are necessary to get the results you want.

 

3-Stage Approach to Vein Treatment2020-09-17T17:58:02-07:00

Do I Need Surgery for Varicose Veins?

2020-09-17T19:01:32-07:00

Non-surgical treatment alternatives for eliminating varicose veins

No! We’ve performed thousands of surgery-free treatments. 

Surgery is rarely performed these days to eliminate varicose veins. Modern endovenous procedures, which were first introduced around the year 2000, have replaced surgery for most patients. Endovenous became the standard of care over vein stripping surgery in 2007.  Treatment can be done in a doctor’s office, without general anesthesia, thereby reducing risks. At our facility, we offer multiple non-surgical treatment options so that vein care is individualized and based on what is best for the patient rather than on what is available. There are multiple non-surgical treatment options, including radiofrequency ablation (RFA), clarivein, laser vein ablation, endovenous laser therapy (EVLA), varithena foam, microfoam, ultrasound guided foam sclerohterapy, ambulatory phlebectomy.

go to our treatments page for more information

 

Do I Need Surgery for Varicose Veins?2020-09-17T19:01:32-07:00
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