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The Vascular Care Group Helps Massachusetts Man Realize His Dream

MIT graduate and software engineer, Bill Cote, had always been an avid biker. Over the course of his working career, the Massachusetts resident would accumulate vacation time, allowing himself three consecutive weeks to enjoy the open road on his beloved bike. In 1984, Bill pedaled from his home in Massachusetts to Ohio, falling short of his Mississippi River goal after an accident left him with a broken toe. In 1986 he rode around Nova Scotia, but inclement weather shortened his trip. In 1989, Bill met his wife Pat and soon after started their family. The dream of long bike rides was relegated to the back burner while he traveled another road, that of husband and father.

In 2015, when his youngest son graduated college, Bill knew he wanted to pursue his passion again. His employer at the time had other ideas and refused to allow the consecutive three weeks off that Bill needed to bike across the Rockies. Later that same year, Bill resigned his position and biked from Pueblo, Colorado, to Jackson Hole, Wyoming, that year.

Bill first learned of peripheral vascular disease, or PAD, when his father received his diagnosis in 1977. Bill’s father had bypass surgery on his leg and remained in the VA hospital for several weeks after post-operative complications. He remembers seeing the incision running the length of his father’s right leg and being shocked at how awful and painful it looked. Eventually his father healed and returned home to a normal life, albeit a little slower than before the surgery. Bill’s father succumbed to another vascular issue, a ruptured aortic aneurysm some years later at the age of 63. Thankfully, much has changed in vascular surgery since that time.

Jump ahead to the start of the pandemic. It is 2020, and Bill was now 63 years old himself. He remembers noting that his right calf was starting to give him trouble. He initially thought it was a pulled muscle and tried to “stretch it out.” But it got to the point where he could barely walk 200 feet. He would experience horrible pain in his right calf. “I would have to take a rest walking up our driveway to our mailbox,” he said.

Bill contacted his PCP, who referred him to Dr. Hoenig at The Vascular Care Group’s Leominster office. Dr. Hoenig found a 6-inch lesion/occlusion in the artery behind his right knee. At that time, conservative therapy was recommended with ongoing exercise, walking through the discomfort. The standard of care remained conservative care and then surgical bypass.

Bill remembers thinking, “I am 63 years old and peripheral vascular disease was giving me a lot of pain and worry. My father’s sudden death at 63 made me think a lot about dying so young too. I began to evaluate how I wanted to spend the rest of my life, so I decided to retire, sold our Carlisle, Massachusetts, home, and moved to Western Massachusetts.”

In 2021, after a year of walking until it hurt too much to continue, and then walking some more, Bill was getting more and more frustrated and longed to be able to go on another bike ride, or at least to be able to walk without pain. He contacted Dr. Hoenig’s office again.

This time, Dr. Hoenig explained to Bill that although most interventionalists would recommend surgical bypass, he had a new office, and with the new setup and advances in technology, he suggested that an attempt could be made to cross the lesion and restore his normal circulation. Bill returned to the office in Leominster, no easy task as they had just moved into their new home nearly two hours away. It proved well worth the trip. Dr. Hoenig performed a popliteal atherectomy and angioplasty using posterior tibial artery pedal access. No stent was used, and Bill had restored circulation to his foot and calf muscle without complication. He was discharged from the recovery room 30 minutes after the procedure with resolution of his discomfort.

It wasn’t long before Bill could walk again without pain. By the summer of 2022, he even started taking long day rides on his bicycle. His first attempt was a ride to Albany; a 75-mile trip. One day out, staying a night in Albany, and riding back home was the plan. Bill’s leg felt free of pain, and he now felt confident the time was right to do the dream bike ride that he had always wanted to do. Since he was retired, he thought, “I have longer than three weeks now; let’s try and ride to Seattle.”

On March 31st, 2023, with snow covering the ground, Bill set off alone on his bicycle from Huntington, Massachusetts. His plan was to bike 50 miles a day for 80 days (4000 miles), take ten rest days along the way, and get to Seattle in 90 days. He made it to Anacortes, Washington, in 88 days.

“My leg did not give me a bit of trouble the whole trip. It was because of the wonderful work of Dr. Hoenig and his team that I was able to live my dream and bicycle across the country. Thank you to Dr. Hoenig and his amazing team for giving me my life back!”

You can read about Bill’s cross-country trip on his blog and see some breathtaking photos of our beautiful country that he snapped along the way. Visit https://billcote.org/.

Dr. Lawrence Garcia Joins The Vascular Care Group, Newton-Wellesley

Internationally recognized physician brings decades of innovative care to the growing group practice.

WELLESLEY, Mass.–(BUSINESS WIRE)–The Vascular Care Group, a state-of-the art practice committed to the prevention, diagnosis and treatment of vascular disease, is pleased to announce that Dr. Lawrence Garcia has joined the Wellesley center. Lawrence A. Garcia, MD, FACC, FAHA, FSCAI, is a Board-certified interventional cardiologist with a focus on peripheral vascular disease. He will work alongside Christopher J. Kwolek, MD, MBA, FACS, R. Todd Lancaster, MD, MPH, RPVI, and Zachary B. Fang, MD, MSc.

“Dr. Garcia brings a wealth of experience in the management of patients with peripheral arterial disease and coronary artery disease, as well as extensive clinical trial experience,” said Dr. Christopher Kwolek. “He has served as a principal investigator on several national and international trials evaluating therapies for peripheral vascular disease. His research has been published in numerous manuscripts and book chapters. In addition, he has served as a course director for many national educational programs and as faculty for more than 50 national and international conferences. He will be an outstanding contributor to our organization and to the management of patients at our Wellesley site.”

Prior to joining The Vascular Care Group, Dr. Garcia received his undergraduate and doctoral degrees from the University of Arizona. He completed his internship and residency at UT-Southwestern, Parkland Hospital in Dallas, Texas. He was a research fellow in the field of aerospace cardiology at that time. He went on to complete additional fellowships in cardiovascular diseases at the University of Iowa Hospital and Clinics, interventional cardiology at the Beth Israel Deaconess Medical Center at Harvard Medical School, and vascular medicine and interventions at St. Elizabeth’s Medical Center at Tufts University School of Medicine. He has since gone on to train over 100 fellows throughout his career.

“Bringing my practice to The Vascular Care Group is a very unique and exciting opportunity,” said Dr. Garcia. “It develops a whole new direction to practice cardiology and interventional medicine in a way that best serves our patients. It remains my greatest honor to be given the privilege of caring for patients and their families as a physician.”

Over the course of his career, Dr. Garcia has directed several multi-center national and international trials for endovascular methods, and his work has earned him numerous accolades including Top Doctor of Boston in Interventional Cardiology by Castle Connolly Associates and Boston’s Top Doctors by Boston Magazine for the past 10 consecutive years. He has been a key contributor in 35 original articles, including being principal investigator for the Definitive LE trial for lower extremity revascularization using directional atherectomy as well as principal investigator in the SUPERB Trial, which was the study that led to the worldwide use of the Supera™ stent. His international recognition has given him the opportunity to lecture all around the world, including Asia, Australia, Europe, and South America.

He is currently a Professor of Medicine at Tufts University School of Medicine in Boston. He is a member of numerous professional societies, including: American College of Cardiology, American Heart Association and the Society of Cardiovascular Angiography and Interventions (SCAI), among others.

“Over the course of my career, I have been given many opportunities. The best ones, however, have been the opportunities to treat patients and their families as well as train physicians in the care of patients with cardiovascular diseases,” Garcia said.

For more information on Dr. Garcia, please visit https://vascularcaregrp.com/providers.

About The Vascular Care Group
The Vascular Care Group (TVCG) is a growing group practice committed to the prevention, diagnosis and treatment of vascular disease. The practice brings together decades of expertise among a team of vascular specialists offering unparalleled care in Massachusetts at five full-service vascular care centers and four additional satellite offices, from Leominster to Cape Cod. Their comprehensive services cover a broad range of conditions from non-invasive vascular testing to complex vascular surgeries, including a full spectrum of open and endovascular procedures performed in-office and at affiliated hospitals throughout the state. The group has united some of the area’s leading vascular experts with a focus on superior patient care.More information about the practice can be found at https://vascularcaregrp.com/.

READ MORE: https://www.businesswire.com/news/home/20220920005023/en/Dr.-Lawrence-Garcia-Joins-The-Vascular-Care-Group-Newton-Wellesley

Dr. Scott D. James Becomes Leading Physician of The Vascular Care Group, Plymouth

Decorated vascular surgeon Dr. James brings over two decades of experience to outpatient care center

PLYMOUTH, Mass.–(BUSINESS WIRE)–The Vascular Care Group (TVCG), announced today the opening of a new, state-of-the-art vascular center, located in Plymouth, Mass. Scott D. James, DO, RPVI will serve as the center’s lead vascular surgeon, bringing over two decades of experience treating a wide array of vascular conditions in and around the Plymouth community. The Plymouth vascular care center will be TVCG’s tenth location in Massachusetts, reinforcing the team’s commitment to the prevention, diagnosis and treatment of vascular disease in Massachusetts communities.

Scott James

Vascular care centers, like this new Plymouth facility, put the patient at the center of the care model,” said Dr. James. “For patients seeking routine vascular care or are in need of minimally invasive, outpatient procedures, our center is focused on improving access to vascular care for the community and putting patients at the center of high-quality, convenient care with dedicated staff who are experts in venous and vascular disease.” With a broad range of patients, Dr. James has experience treating a variety of vascular conditions from dialysis to cosmetic vein care to carotid artery disease.

Prior to joining The Vascular Care Group, Dr. James spent 18 years practicing at Beth Israel Deaconess Hospital – Plymouth, formerly Jordan Hospital, where he serves as the hospital’s Wound Center Medical Director. The Vascular Care Group collaborates with community hospitals and Dr. James and his team will continue to offer around-the-clock vascular care to BID Hospital – Plymouth and continue to perform in-patient, open surgical procedures at the hospital, if that is the best course of treatment for the patient.

“Over the past couple of years, we have seen patients neglecting important routine vascular care,” said Dr. James. “My hope is that patients will recognize the convenience and quality of our center and seek out the necessary and, at times, lifesaving care they need. I am eager to continue to provide the Plymouth community with access to quality vascular care at this brand-new facility, while also continuing my long-standing support and commitment to Beth Israel Deaconess Hospital – Plymouth.”

TVCG is committed to improving the patient experience and access to vascular care by making the healthcare process more convenient in a high-quality setting centered around patient care. Utilizing the most cutting-edge and innovative techniques, TVCG provides minimally invasive treatments while eliminating the need to travel far for quality vascular care. Dr. James will be joined in Plymouth by nurse practitioner, Regina Chandler.

About The Vascular Care Group
The Vascular Care Group (TVCG) is a growing group practice committed to the prevention, diagnosis, and treatment of vascular disease centering its treatment model around optimizing the patient experience, providing advanced vascular interventions outside the traditional hospital setting, and reducing costs for patients and payers. TVCG fundamentally improves access to much needed vascular care, focusing on community settings, including around-the-clock service and support to more than twelve community hospitals in Massachusetts. The practice brings together decades of expertise among a team of vascular specialists offering unparalleled care in Massachusetts at six full-service vascular care centers with four satellite offices, from Worcester to Cape Cod. Their comprehensive services cover a broad range of conditions from non-invasive vascular testing to complex vascular surgeries, including a full spectrum of open and endovascular procedures performed in-office and at affiliated hospitals throughout the state. Each care center has united some of the area’s leading vascular specialists with a focus on superior patient care. More information about the practice can be found at https://vascularcaregrp.com/.

READ MORE: https://www.businesswire.com/news/home/20220718005723/en/Dr.-Scott-D.-James-Becomes-Leading-Physician-of-The-Vascular-Care-Group-Plymouth

Not Your Mother’s Varicose Vein Surgery

If you have squiggly, bulging veins in your legs that look like a version of a road map, you are among the 35 percent of people living in the United States who have varicose veins, according to the Society for Vascular Surgery.

“Varicose veins develop in the superficial veins just under the skin,” said Daniel R. Gorin, MD, RVT, FACS, a vascular surgeon with the Vascular Care Group in Hyannis. “They can become uncomfortable, achy, burning, itchy and sometimes as the skin thins over them, they can rupture and bleed. You can develop swelling in your legs, changes in the skin and tissues resulting in chronic venous insufficiency leading to ulcers.”

Unlike the deep veins in the legs that do all the work of circulation in your legs, these are minor veins that aren’t that important to circulation, explained Dr. Gorin. It is a problem you are likely born with and, overwhelmingly, people who develop varicose veins have someone in their family who had them.

“For those patients who say they don’t, they never saw their grandmother in shorts,” he said.

The changes that cause veins to stretch and bulge are attributed to the one-way valves in your veins that weaken over time and begin to leak, he added. This causes pressure inside the vein when the valve doesn’t close completely, allowing blood to leak back down the veins instead of flowing up towards the heart.

Doctor's quote about vascular treatment

New Minimally Invasive Treatments

In the past, faulty veins were removed using vein stripping surgery that involved pulling the veins out of the leg, which required the use of general or spinal anesthesia and often resulted in bruising and scarring. But now there are better more effective and less invasive options for patients, according to Dr. Gorin. Newer techniques now seal off the veins using endovenous ablation, he said. These are minimally invasive procedures that use either radiofrequency energy or laser energy to burn the inside of the veins and close them off. Blood flow then reroutes through other veins.

“The procedure is done in the office, and it takes about 10 minutes,” he said. “Basically, we numb your skin with Novocaine, thread a little needle into the vein, followed by a guidewire and then a special catheter up the vein. As the catheter is withdrawn, we can either use radiofrequency energy or laser light energy to burn the inside of the vein, which makes it collapse. You get a band aid, put on elastic stockings, and you walk out. No pain, no scars. You can return to your usual activities right away.”

“It has been a wonderful advance instead of doing the stripping surgeries. It deflates their varicose veins, and it makes patients feel a lot better,” said Dr. Gorin.

Marilyn Sink, a retired schoolteacher, recently had a radiofrequency ablation done with Dr. Gorin. She had noticed a bulging varicose vein just below her knee and became concerned that it could bleed if it got accidentally hit or injured, especially with her active lifestyle working in the garden and exercising.

“My skin is very thin in that particular area, which gets bumped a lot and is kind of exposed,” she said.

After a three-month trial of wearing a compression stocking as an initial treatment, Dr. Gorin and Sink decided to treat the vein.

“The procedure went fine and the way he said everything would,” said Sink. “It went quite fast, and I was out in an hour.”

The next day she went to her yoga class and was back to doing many of her normal activities.

The Vascular Care Group Welcomes Nationally Recognized Vein Expert Dr. Harold J. Welch

Decorated physician brings 30+ years of experience to patients on Cape Cod

HYANNIS, Mass.–(BUSINESS WIRE)–The Vascular Care Group (TVCG), a state-of-the art practice committed to the prevention, diagnosis and treatment of vascular disease, is pleased to announce that Harold J. Welch, MD, FACS, RVT, RPVI has recently joined the Hyannis, Mass. location. Recognized as one of Boston’s “Top Doctors” in Boston Magazine multiple times, Dr. Welch brings more than 30 years of surgical experience and expertise to patients seeking care for all facets of vascular surgery on Cape Cod and the islands.

Harold J. Walsh

With over twenty years of experience running his own private practices, Dr. Daniel Gorin, founding partner of The Vascular Care Group and board member of Mangrove Management Partners, is well-versed in what it takes to make a practice successful. For the last eight years, he has been the lead vascular surgeon at The Vascular Care Group’s Hyannis location, one of the first outpatient endovascular care centers in Massachusetts. His center also serves as a key location for The Vascular Care Group, training new staff and serving as a support system for TVCG’s other locations.

“The Vascular Care Group has established a model that delivers high-level care to patients in the communities where they live, rather than asking the patient to travel to a larger city or healthcare hub,” said Dr. Welch. “I firmly believe that we can lower the barrier to quality care and improve the patient experience with a commitment to outpatient care in our communities. It is very exciting to join a like-minded organization that is a leader in outpatient vascular care in Massachusetts.”

Prior to joining The Vascular Care Group, Dr. Welch worked as a vascular surgeon at Lahey Clinic in Burlington, Mass. for 24 years. He developed an international reputation for excellence while operating in hospitals across the globe, including U.S. Naval Hospitals in Groton, Conn., Portsmouth, Va and Keflavik, Iceland. He also spent time at the Tufts-New England Medical Center before moving to the Lahey Clinic.

“By increasing access to highly skilled physicians, such as Dr. Welch, our team is helping to improve the care paradigm on Cape Cod,” said Daniel R. Gorin, MD, RVT, FACS, a founding partner at TVCG. “I look forward to working with him and continuing our mission to innovate the delivery of vascular care on a community level.”

Dr. Welch was named an American Venous Forum Distinguished Fellow and received the Cornelius Sedgwick Mentor Award for Surgery Chief Residents. He is a member of several professional societies, including American College of Surgeons, Society for Vascular Surgery, and the New England Society for Vascular Surgery, and has served as a Professor of Surgery at Tufts University School of Medicine and President of the American Venous Forum. Dr. Welch has also authored 11 book chapters and more than 30 articles.

About The Vascular Care Group

The Vascular Care Group (TVCG) is a growing group practice committed to the prevention, diagnosis, and treatment of vascular disease centering its treatment model around optimizing the patient experience, providing advanced vascular interventions outside the traditional hospital setting, and reducing costs for patients and payers. The practice brings together decades of expertise among a team of vascular specialists offering unparalleled care in Massachusetts at four full-service vascular care centers with five satellite offices, from Worcester to Cape Cod. Their comprehensive services cover a broad range of conditions from non-invasive vascular testing to complex vascular surgeries, including a full spectrum of open and endovascular procedures performed in-office and at affiliated hospitals throughout the state. Each care center has united some of the area’s leading vascular specialists with a focus on superior patient care. More information about the practice can be found at https://vascularcaregrp.com

READ MORE: https://www.businesswire.com/news/home/20220314005650/en/The-Vascular-Care-Group-Welcomes-Nationally-Recognized-Vein-Expert-Dr.-Harold-J.-Welch

Congratulations to Dr. Christopher J. Kwolek and Dr. R. Todd Lancaster on being named Top Doctors™ 2022 by Boston Magazine!

Congratulations to Dr. Christopher J. Kwolek and Dr. R. Todd Lancaster on being named Top Doctors™ 2022 by Boston Magazine! The region’s finest physicians, each nominated by their peers and rigorously vetted, received this coveted award. We are so proud of both Dr. Kwolek and Dr. Lancaster! Learn more here: https://www.bostonmagazine.com/health/2022/01/25/top-doctors-boston-area/

Dr. Daniel Gorin of The Vascular Care Group: 5 Things You Need To Know To Create a Highly Successful Private Practice

Support your people. — Empower those who work for and with you. Great leaders often use the term “we” and not “me,” so let your employees take credit for their successes and encourage them to learn from their mistakes

As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Dr. Daniel R. Gorin.

Daniel Gorin

With over twenty years of experience running his own private practices, Dr. Daniel Gorin, founding partner of The Vascular Care Group and board member of Mangrove Management Partners, is well-versed in what it takes to make a practice successful. For the last eight years, he has been the lead vascular surgeon at The Vascular Care Group’s Hyannis location, one of the first outpatient endovascular care centers in Massachusetts. His center also serves as a key location for The Vascular Care Group, training new staff and serving as a support system for TVCG’s other locations.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?

I have been in practice for over twenty years and have evolved along with vascular surgery as it has grown and changed. I have been lucky to have worked on the forefront of vascular surgery as it transitioned into a minimally invasive specialty that allows us to treat a large portion of our patients in outpatient care facilities. This shift separated me from those I was working with in general surgery whose specialties required them to be hospital employed. As they started to leave, I took over the practice and began wondering why my colleagues in vascular surgery were not taking advantage of the changes in the field and moving into outpatient care facilities like myself. As I built a vein center and an outpatient endovascular suite to accommodate vascular patients outside of the hospital, I did not see others in the New England area follow suit with the same trends that were occurring across the country. Many of these physicians were stuck in their circumstances with too heavy of a lift to make the move. Luckily, I met a group of individuals with similar goals for outpatient vascular care and we formed Mangrove Management Partners. Together, we developed a network of physicians called The Vascular Care Group (TVCG), where I am the executive partner.

With both Mangrove and TVCG, we were ultimately able to build the infrastructure to move talented vascular surgeons into private practice. Not only did this allow us to have more control over the care we were providing to patients but have more control over the way our practices are run. Over the past two years, this change has been successful and has grown TVCG from just me and my practice in Hyannis to a practice of 14 vascular surgeons and multiple other practices across Massachusetts.

I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?

All surgeons are trained through apprenticeships. I did my fellowship under Dr. James Menzoian who was the Chief of Vascular Surgery at Boston University when I was completing my residency. He was a big mentor for how I approach my job from a clinical standpoint.

When most surgeons are learning their craft, they do not get a chance to also learn the business side of surgery. However, I was lucky to have my father as a huge inspiration. He owned one of the largest ophthalmologist practices in Connecticut and as his practice continued to grow, he taught me how to successfully run a business. As I went into private practice, I did not initially open my own, I joined a general surgery practice as a vascular surgeon. My time there gave me the opportunity to observe my senior partners who had far more experience.

What made you want to start your own practice? Can you tell us the story of how you started it?

I was lucky to have built a very successful individual private practice. As that was very rewarding, I wanted to do something bigger in the larger community. I looked at my fellow colleagues in vascular surgery and wondered why they too were not joining or opening their own outpatient clinics. With the goal of building upon my clinic, I joined with a number of talented people to form Mangrove Management Partners and developed The Vascular Care Group into a partnership of respected Massachusetts vascular physicians with four full-service vascular care centers and five satellite offices, from Worcester to Cape Cod. Ever since, TVCG has been expanding and evolving at a rapid pace, providing superior patient care.

Can you share the most interesting story that happened to you since you began your career?

A big change in my career occurred when I switched from being an individual private practice doctor to forming The Vascular Care Group, because it meant shifting from everything in the business revolving around me to a group where many other physicians and staff were involved. Instead of just worrying about myself and my own clinic, I became part of a larger network of specialized physicians as well as business professionals. We have transformed vascular care to be better for patients. We provide patients with easy access to patient centered care in their communities.

Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?

You have to remember that healthcare is a business. Every hospital is a business; it may be a nonprofit, but it has a fiduciary responsibility. Physicians in a large health system are several steps away from the business side of care, so they don’t feel the same fiduciary responsibility as a physician in private practice.

At one of our vascular conferences, a paper was presented that looked at these very expensive stents that we use to fix abdominal aneurisms. These procedures are done in the hospital and the overwhelming majority of the cost of the procedure comes from the stents. The researchers got doctors involved and looked at the cost of all the different devices and worked out a process to negotiate for lower prices. But this made me think that the best way we could achieve lower prices would be to pay the physicians a little more to do the procedure and have them buy the device themselves.

We have found that when physicians have “skin in the game” and have to research the medical devices they use and the financial investment in those devices, it can help them make the most economically responsible and best decisions for their patients. We, as physicians, need to make these important decisions but we also need to be impacted by these decisions. I think if you divorce yourself from the business end, you are doing no one a favor.

Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?

Being a provider and business owner are one in the same when you run your own private practice. If I do not run a successful practice, I cannot take care of my patients. I am responsible not only for myself but for everyone who works with me at my practice. Therefore, everything I do as a physician generates the revenue that pays for all these moving parts. If I do not make responsible decisions to run a profitable practice, then my nurse or my scheduler cannot do their jobs. As a private practice owner, I am responsible not only for my patients but also for my staff who keep the entire place running. This is a huge responsibility that I take very seriously. There is no way to run a successful private practice as a physician when you separate being a provider and a business owner.

From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?

When I originally began practicing vascular surgery, it was not identified as a separate specialty. Most of the surgeons I was working with, including myself, were part of a multi-specialty surgical group. As my specialty matured, my colleagues found that their specialties would have a tough time surviving in the private practice model. Many of these surgeons were forced to join hospitals to accommodate their specialties. As they began leaving the practice, I had to navigate how to take over ownership of the bigger practice. As a business owner, I had to put myself in everyone else’s shoes and really understand their stressors and concerns as the practice was growing and changing.

Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)

1.) Work with great people.
When you work with talented and passionate people who align with your own personal and professional goals, you will achieve great things together.
2.) Support your people.
Empower those who work for and with you. Great leaders often use the term “we” and not “me,” so let your employees take credit for their successes and encourage them to learn from their mistakes.
3.) Always grow.
Never sit still or be content with where you are at. Be relentless in finding ways to improve. Successful businesses and practices foster a culture that encourages growth and celebrates change.
4.) Support your colleagues in your medical community.
Support the physicians in your specialty, work alongside them, and be a resource for others to benefit the greater good for patients.
5.) Be a sponge.
You do not know what you do not know. Be ready to learn, visit other practices, and formulate relationships so you can learn from people in other communities who are solving problems in new ways. Join your societies as well. I am a big supporter of the OEIS (Outpatient Endovascular and Interventional Society), an organization I have been a member and leader of since its early days.

As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?

When I was a general surgery resident, our chief Dr. Peter Deckers, would always tell us when he saw us outside the operating room “it’s time for scholarship.” By this he meant, although you are not in surgery, find something to do to make your time productive. For me, in addition to my patient care, the business end of my practice is not separate. Whenever I have downtime, I am always trying to make use of it and work on my practice whether it be as simple as sending an email or making a call. My staff jokes that it is a really good idea to keep me busy because if I have a little downtime, I will come up with some project for us to do. You have to be engaged all the time and the business elements must be part of your thinking. This also goes both ways; on days I am not seeing patients, I am still a doctor. I either go to the hospital to see patients or talk with my nurse practitioners about another patient.

I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?

It is simply not healthy to center your whole life around your career. Vascular care is my career, so of course I am proud of what I do and am excited by it, but it does not define me as an individual. It is extremely important to have a life outside of my career. For example, singing is a huge passion of mine. For over 25 years, I have been a member of a small acapella group in the Boston area called The Works. We started the group when I was a vascular fellow and it is comprised of phenomenal musicians, all of whom are successful professionals in various fields. None of them are physicians and they do not want to talk about medicine when we are together, so this is truly my time away from my day job. Once a week, I drive to the Boston area, rehearse for a couple of hours with people I consider family, and spend time focusing on music. Unfortunately, the pandemic put a pause on our performances, but we will be at the American Acapella Alliance in Bar Harbor, Maine in May 2022.

It is vital to have hobbies, especially when your job is as demanding as mine is. Music is very important to me, and I make sure to devote time to it as much as possible. Whether your passion lies in music or sports or anything else, I recommend keeping it in your life.

Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?

I was out to eat with a great friend of mine, fellow vascular surgeon, Dr. Bob Tahara. He practices in rural Pennsylvania and is one of the only vascular surgeons for four hours in any direction. Bob and I met at a course in Grand Rapids, Michigan. It was snowing and below freezing, but we made it with our group to a steakhouse. After ordering some wine, the waiter told us about the specials: ribeye steak and a special filet mignon, and both sounded delicious. I turned to Bob and said, “the special sounds great but I really love ribeye.” Bob replied with a quote from the author Robert Heinlein who said, “when given the choice between being a live jackal and a dead lion, I always choose to be a live lion.” He turned to the waiter and said, “I will have the special but with ribeye.”

The life lesson is don’t let other people define your life choices. Be a live lion, make your own choices, and forge your own path.

How can our readers further follow your work online?

https://www.linkedin.com/in/daniel-gorin-688b2a41/
https://vascularcaregrp.com/
https://www.facebook.com/The-Works-Bostons-Favorite-A-Cappella-Singing-Group-181771048718/

READ MORE: https://medium.com/authority-magazine/dr-daniel-gorin-of-the-vascular-care-group-5-things-you-need-to-know-to-create-a-highly-successful-1b9659ade55a

Congressman James McGovern visits Leominster’s Vascular Care Group to discuss concerns over sub-specialties cuts

(L. to r.) Congressman James McGovern sat down with Dr. Stephen Hoenig, Mangrove Management Partners CEO Mark Rowe, and Dr. Sebastian DiDato at The Vascular Care Group in Leominster in December to discuss concerns over Centers for Medicare & Medicaid Services cuts and how they can affect patient care. (COURTESY THE VASCULAR CARE GROUP)

LEOMINSTER — U.S. Rep. James McGovern visited The Vascular Care Group in December to listen to staff concerns about the Centers for Medicare & Medicaid Services recently announcing cuts to various sub-specialties, including vascular care.

“As COVID-19 cases and hospitalizations rise, these cuts will only further the strain on health care systems as patients delay preventative care and arrive in already overloaded emergency rooms,” said Dr. Stephen Hoenig, lead physician at The Vascular Care Group.

Hoenig is a longtime vascular surgeon and founding member of the practice group. He said that ultimately the cuts “disproportionately impact independent physician practices who care for patients with critical, life-threatening conditions.”

“On average, a procedure done at my office is about 28% less than what’s billed at a large health care system,” he said. “Thus, to further cut us when we are already helping to keep costs down is hard. This, in turn, could ultimately limit the number of services available to patients and largely impact disadvantaged communities.”

Congressman James McGovern (l.) visited The Vascular Care Group in Leominster in December and spoke with staff about concerns over Centers for Medicare & Medicaid Services cuts, including Dr. Sebastian DiDato, Dr. Stephen Hoenig, and Mangrove Management Partners CEO Mark Rowe. (COURTESY THE VASCULAR CARE GROUP)

Congressman James McGovern (l.) visited The Vascular Care Group in Leominster in December and spoke with staff about concerns over Centers for Medicare & Medicaid Services cuts, including Dr. Sebastian DiDato, Dr. Stephen Hoenig, and Mangrove Management Partners CEO Mark Rowe. (COURTESY THE VASCULAR CARE GROUP)

Hoenig and his colleagues at the center invited McGovern to visit to discuss the pressing issue and ask for his help when it comes to lessening the impact of the cuts.

“It was an important step in ensuring representatives understand the impact of the (Centers for Medicare & Medicaid Services) cuts and work to make changes that will protect patients,” Hoenig said. “Congressman McGovern listened intently, he clearly understands the challenges and we certainly hope that by being here he can help bring further action to stem the cuts. Efforts are underway in Congress now and hopefully he can advocate on this matter, which I believe he will do and for which I’m grateful.”

“It was wonderful to meet with Dr. Hoenig and his team, who are bringing state-of-the-art vascular care to the greater Leominster area,” McGovern said. “I admired their dedication to innovative patient care and their commitment to our community hospitals, and I will continue to advocate for fair Medicare reimbursement rates for the critical services provided to patients by Dr. Hoenig and other surgeons throughout the Second District.”

The team at The Vascular Care Group provides state-of-the-art outpatient care, making peripheral vascular and venous treatments more convenient and patient-centric.

“This practice is playing an increasingly important role in minimizing strain on larger health systems and reducing the cost of care for patients who do not require treatment in a hospital,” Hoenig said. “Patients without access to good care, or those who ignore their symptoms, will suffer from life-threatening issues that could result in limb removal or even death.”

When it comes to the Centers for Medicare & Medicaid Services cuts, the surgeon said some endovascular procedure codes are being cut by up to 20%.

“There’s legislation in Congress now that would limit those cuts to single digits, which seems to be a best-case scenario at this stage, which is unfortunate,” Hoenig said. “My practice is a member of the CardioVascular Coalition, and we are working with them and the medical societies in order to inform Congress about the importance of withholding theses cuts as it is in the best interests of patients and physicians.”

Hoenig said “it was a pleasure” having McGovern at their Leominster center, one of nine locations across the state, and “being able to show him first-hand how I, my team, and my partners are trying to change the paradigm of the delivery of care helped to put into perspective how we can provide better outcomes and patient experiences at a lower cost.”

“Congressman McGovern truly listened to us, spent time with our team and patients, and I thank him very much for being an advocate on Capitol Hill during a time when Medicare continues to put pressure on reimbursements for surgical procedures in office-based settings,” Hoenig said.

He went on to say that he appreciates that McGovern “took a particular interest” in getting to know him and his staff “and to truly understand what we do.”

“A lot of physicians across the country are making noise about this, but (Centers for Medicare & Medicaid Services) will sometimes only respond if forced to by Congress,” Hoenig said. “What I truly hope Congressman McGovern can help further champion is fundamental change so this year-after-year cycle of proposed cuts by (Centers for Medicare & Medicaid Services), followed by intense lobbying, followed by Congressional intervention can eventually result in something more predictable over longer periods of time.”

READ MORE: https://www.sentinelandenterprise.com/2022/02/09/congressman-mcgovern-visits-leominsters-vascular-care-group-to-discuss-concerns-over-sub-specialties-cuts/

Congratulations to Dr. Edward Arous

Congratulations to Dr. Edward Arous who was recently appointed to the Society for Vascular Surgery Young Surgeons Section Steering Committee! The committee’s mission is to foster and accelerate the learning and career development of young surgeons within the first 10 years of practice. Dr. Arous is one of 12 young surgeons on the committee. Learn more

Vascular surgeon successfully completes first procedure of its kind at Leominster outpatient center

LEOMINSTER — Longtime vascular surgeon and founding member of The Vascular Care Group, Dr. Stephen Hoenig recently completed a successful percutaneous femoral-popliteal artery bypass at its Merriam Avenue location, the first procedure of its kind in the state in an outpatient setting.

“With any new procedure there is always freshman anxiety,” Hoenig said of the breakthrough procedure. “I have an excellent team that gave me confidence and assisted in every part of the process.”

The procedure is used to treat a blocked femoral artery, the largest artery in the thigh that supplies oxygen-rich blood to the leg. According to a press release, the percutaneous bypass graft is used to restore blood flow to the lower leg and foot using a minimally invasive technique that avoids hospitalization and long recovery.

“Although I did not invent this procedure, I am proud to bring it to my community,” Hoenig said. “This, along with many of the minimally invasive procedures we now perform in the outpatient facility, I believe, are transformative in the world of vascular surgery and patient care. It gave me great joy and satisfaction to provide this service to my patients.”

Vascular surgeon and founding member of The Vascular Care Group Dr. Stephen Hoenig (far right) with his team, including Dr. Sebastian DiDato (far left), who helped him successfully complete a percutaneous femoral-popliteal artery bypass recently at the Leominster location, the first procedure of its kind in the state in an outpatient setting. (COURTESY THE VASCULAR CARE GROUP)
Stephen Hoenig

Vascular surgeon and founding member of The Vascular Care Group Dr. Stephen Hoenig (far right) with his team, including Dr. Sebastian DiDato (second from left), who recently helped him successfully complete a percutaneous femoral-popliteal artery bypass at the Leominster location, the first procedure of its kind in the state in an outpatient setting. (COURTESY THE VASCULAR CARE GROUP)

Leominster office

Vascular surgeon and founding member of The Vascular Care Group Dr. Stephen Hoenig and his medical team recently completed a successful percutaneous femoral-popliteal artery bypass at the Leominster location, the first procedure of its kind in the state in an outpatient setting. (COURTESY THE VASCULAR CARE GROUP)

Hoenig said they have now completed the minimally invasive procedure, which decreases recovery time, on two patients under mild-conscious sedation.

“Both patients watched the procedure being performed on the monitor and had only minimal discomfort,” he said. “This procedure assists in keeping patients out of the hospital where they otherwise may have required a three-to-five-day hospitalization for recovery. My patients walked out of my office one hour after the procedure.”

According to a press release the procedure was part of an investigational device exemption trial called Detour2 Continued Access (NCT04625660), sponsored by Endologix LLC. The trial is evaluating the safety and effectiveness of the PQ Bypass System for a percutaneous femoral-popliteal bypass procedure. The PQ Bypass System was designated as a U.S. Food and Drug Administration Breakthrough Device in 2020.

The Vascular Care Group’s Merriam Avenue Leominster location, where Dr. Stephen Hoenig and his medical team recently completed a successful percutaneous femoral-popliteal artery bypass, the first procedure of its kind in the state in an outpatient setting. (COURTESY THE VASCULAR CARE GROUP)

“By offering this type of minimally invasive procedure in the outpatient setting, we can help patients avoid a surgical incision, hospitalization and postoperative recovery,” said Hoenig. “The patient was discharged … after the procedure with no discomfort and only two small, quarter-inch access incisions. This clearly changes our approach to limb threatening disease. I feel privileged to be one of the first vascular surgeons in Massachusetts to perform the procedure.”

With this new procedure, The Vascular Care Group is providing new technologies and techniques to community physicians working outside of large research centers, enabling greater access to medical innovation in a safe, efficient, patient-friendly setting. It marks another step in granting communities access to cutting-edge technology on a local level at a lower cost, without requiring a trip to a major city, or a long hospital stay.

Hoenig has been a vascular surgeon for 22 years and helped found The Vascular Care Group in January 2020, which has nine locations across the state.

READ MORE: https://www.sentinelandenterprise.com/2022/01/14/vascular-surgeon-successfully-completes-first-procedure-of-its-kind-at-leominster-outpatient-center/