Setting up sclerotherapy in a phlebology practice

Abstract

Sclerotherapy is routinely performed only by licensed physicians in most countries, but whether other medical providers are allowed to do so may vary according to individual governmental regulations. In many states in the U.S., registered nurses are allowed to do sclerotherapy, while others authorize sclerotherapy by physician assistants and nurse practitioners. Permitting only physicians to perform sclerotherapy while excluding the practice by nurses, seems to fly in the face of the fact that nurses routinely inject patients with potentially lethal medication as a matter of standard nursing practice. The reason it makes a difference as to who should be doing sclerotherapy is that in a phlebology practice, the physician's time can be much more productive performing more complex procedures than sclerotherapy. Certainly the physician should be quite adept at sclerotherapy, since many of the skills required to do sclerotherapy are directly related to the performance of other phlebologic procedures. But as patient volume in a phlebology practice grows, sclerotherapy is one of the tasks that may readily be assumed by other members of the staff, leaving the physician time to interact with patients in consultations, perform diagnostic testing as needed, and treat patients using more complicated modalities that do not lend themselves to performance by other staff members. However it is necessary to consult governmental regulations to be certain the phlebology practice is operating within appropriate guidelines.