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Vascular Health for Busy Professionals

If you’re like many professionals, juggling a hectic schedule from dawn till dusk, health often takes a backseat to deadlines and meetings. Grabbing a coffee to go, skipping meals, and sitting through marathon Zoom calls have become the norm. But amidst this chaos, one aspect of your health silently demands attention — your vascular health. Unlike a missed email or a postponed meeting, neglecting it can lead to serious consequences.

This guide isn’t about adding another task to your overwhelming to-do list; it’s about seamlessly integrating simple, life-changing habits into your routine to ensure your blood vessels get the care they deserve.

Understanding Vascular Health

Before diving into strategies for maintaining vascular health, it’s crucial to understand what vascular health entails. The vascular system comprises arteries, veins, and capillaries that carry blood throughout the body, delivering essential oxygen and nutrients to organs and tissues. When the vascular system functions optimally, blood flow remains unimpeded, supporting overall health and vitality.

The Impact of Busy Lifestyles on Vascular Health

Busy professionals often face multiple challenges that can negatively impact vascular health. Prolonged periods of sitting, high stress levels, poor dietary choices, and lack of exercise are common factors in modern work environments. These aspects can contribute to conditions such as high blood pressure, obesity, and diabetes, all of which increase the risk of vascular diseases like atherosclerosis and peripheral artery disease.

Practical Strategies for Vascular Health

  1. Move More, Sit Less: Incorporate regular movement breaks into your workday. Take short walks, stretch at your desk, or use a standing desk to reduce prolonged sitting.
  2. Prioritize Exercise: Schedule regular exercise sessions, even if they’re short. Aim for a mix of cardiovascular exercises, strength training, and flexibility exercises to promote overall vascular health.
  3. Eat a Balanced Diet: Opt for nutrient-dense foods such as fruits, vegetables, lean proteins, and whole grains. Limit intake of processed foods, sugary snacks, and high-sodium meals, which can contribute to vascular issues.
  4. Manage Stress: Practice stress-reduction techniques such as deep breathing, meditation, yoga, or mindfulness exercises to alleviate stress and promote relaxation.
  5. Get Regular Check-ups: Schedule regular appointments with a vascular care provider for preventive screenings and assessments. Early detection of vascular issues can lead to better outcomes and treatment options.

Seeking Professional Guidance for Vascular Care

If you’re experiencing symptoms such as chest pain, leg cramps, or numbness in your extremities, seeking prompt medical attention from a vascular care provider is essential. At The Vascular Care Group, our team of experienced specialists offers comprehensive vascular care services, including diagnosis, treatment, and management of various vascular conditions.

Explore our services, including vascular screenings, minimally invasive procedures, and surgical interventions, to ensure your vascular health remains a top priority. Don’t let a busy schedule compromise your well-being—take proactive steps to protect your vascular health today.

Contact The Vascular Care Group Today!


At The Vascular Care Group, we’re dedicated to providing comprehensive vascular care that fits your busy schedule. With locations across New England, our team of experienced vascular specialists is here to support you with state-of-the-art treatments and compassionate care. Whether you’re looking for preventive care or need treatment for a vascular condition, we’re here to help.

Ready to prioritize your vascular health? Schedule a consultation today and discover how we can assist you in leading a healthier, more vibrant life.

Exploring the Benefits of Compression Socks for Vein Health

Have you ever ended a long day with legs that feel like they’ve run a marathon, even if you’ve barely left your desk? It’s a common plight signaling poor circulation and potential vein health issues, but there’s a surprisingly simple solution: compression socks. These aren’t just for athletes or seniors; they’re a secret weapon for anyone looking to boost their vein health and enjoy comfort, whether at work, during travel, or in daily activities.

Join us as we unravel the science behind compression socks and how they can be your legs’ new best friend.

The Science Behind Compression Socks

Compression socks are designed to promote blood flow by applying gentle pressure to your legs and ankles, helping the blood vessels work better. Blood flows more freely back to your heart, reducing swelling, preventing blood clots, and alleviating symptoms associated with varicose veins and other venous disorders. They’re not just for travelers or hospital patients; anyone can benefit from the enhanced circulation they provide.

Benefits for Everyday Health and Activity

  1. Improved Circulation: By promoting blood flow, compression socks can help reduce the risk of developing deep vein thrombosis and other circulation-related issues.
  2. Reduced Swelling and Pain: Regular compression socks wearers report significantly less swelling and pain in their legs, especially towards the end of the day or after long periods of standing or sitting.
  3. Enhanced Athletic Performance: Athletes find that compression socks support muscle recovery after exercise by minimizing muscle soreness and fatigue.
  4. Support for Varicose Veins: Wearing compression socks can alleviate discomfort from varicose veins and may help prevent new ones from developing.
  5. Travel Companion: During long flights or car rides, compression socks can be a game-changer in preventing deep vein thrombosis and leg swelling.

Choosing the Right Compression Socks

Not all compression socks are created equal. It’s essential to choose the right level of compression for your needs, generally measured in millimeters of mercury (mmHg). A lower compression level might be sufficient for everyday wear, while those with specific vein health concerns may require a higher level. Consulting with a healthcare professional or a vascular care specialist can provide guidance on the best choice for you.

Take the Next Step Towards Healthier Veins With The Vascular Care Group

Our team at The Vascular Care Group is dedicated to providing our patients with the highest level of care. With state-of-the-art facilities across New England and a team of experienced specialists, we offer comprehensive vascular care services tailored to each patient’s needs. 

If you’re experiencing discomfort or want to learn more about improving your vein health, we are here to help. Visit our website to find a location near you. Our team is committed to providing personalized care and the latest treatments to keep your veins healthy for years to come.

The Role of Diet and Exercise in Vascular Health

The journey to maintaining optimal vascular health is a multifaceted endeavor that extends far beyond the confines of traditional medicine. It encompasses the very lifestyle choices we make daily, particularly in the realms of diet and exercise. As we navigate through the complexities of modern living, understanding the profound impact of these elements on our vascular system becomes paramount. 

This blog aims to shed light on how diet and exercise play crucial roles in promoting vascular health and why incorporating them into your routine can lead to a healthier, more vibrant life.

Diet’s Impact on Vascular Health

A balanced diet acts as the cornerstone of good vascular health. Nutrient-dense foods not only nourish our bodies but also protect our blood vessels from damage. Here are key dietary principles to support vascular health:

  • Whole Foods Over Processed: Opt for fruits, vegetables, whole grains, and lean proteins. These foods are rich in antioxidants and phytochemicals that help reduce inflammation and oxidative stress, protecting the vascular walls.
  • Limit Saturated Fats and Sodium: Excessive intake of saturated fats and sodium can contribute to the buildup of plaque in the arteries and high blood pressure, respectively. Moderation is key.
  • Increase Fiber Intake: Dietary fiber found in fruits, vegetables, and whole grains helps reduce cholesterol levels, thus lowering the risk of vascular disease.
  • Stay Hydrated: Adequate water intake is essential for maintaining the elasticity of blood vessels and ensuring proper circulation.

The Role of Exercise in Vascular Health

Regular physical activity is equally essential in maintaining vascular health. Exercise helps by:

  • Improving Blood Flow: Regular exercise enhances circulation, ensuring that nutrients and oxygen are efficiently distributed throughout the body.
  • Reducing Blood Pressure: Physical activity can help lower blood pressure by keeping the blood vessels flexible and strong.
  • Strengthening the Heart Muscle: Like any muscle, the heart becomes stronger with exercise, improving its ability to pump blood effectively.
  • Weight Management: Exercise aids in weight control, which is vital since obesity is a significant risk factor for vascular diseases.

Incorporating at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous activity each week, along with muscle-strengthening exercises on two or more days a week, can significantly benefit your vascular health.

Balancing Act: Combining Diet and Exercise

The synergy between diet and exercise creates a powerful duo for vascular health. While a healthy diet ensures the right nutrients are available for the body’s needs, regular exercise utilizes these nutrients to strengthen and maintain the vascular system’s integrity. Together, they reduce the risk of developing vascular diseases, enhance energy levels, and improve overall well-being.

Embrace Your Health with The Vascular Care Group

At The Vascular Care Group, we understand that every individual’s journey to optimal vascular health is unique. Our world-class, comprehensive vascular care services are tailored to meet your specific needs, guiding you through every step of your journey towards a healthier life. Whether you’re seeking preventive advice, diagnostic services, cutting-edge treatments, or managing an existing vascular disease diagnosis, our team of experts is here to support you.

Reach out to The Vascular Care Group and discover how we can help you achieve optimal vascular health in New England.


Marlene Chaisson Story

Oh YES, there will be dancing…thanks to the experts at The Vascular Care Group

North central Massachusetts is home to 78-year-old Marlene Chaisson, whom friends and family have always referred to as the energizer bunny.  Now retired, Marlene worked for many years as an account manager and enjoyed a second career working in the fitness industry.  According to her, “I’m not happy unless I’m up and about and I believe wholeheartedly that the more we move, the healthier we will be!”

Marlene has always remained active, enjoying activities like 2–3-mile walks and hikes, riding her road bike for 10-30 miles depending on the day, and walking in the sand at the beach.  However, when she began to notice that the activities she loved so much became more challenging, she knew she needed to seek medical advice.  It was spring 2010 when she first encountered Dr. Hoenig.  The team, including the outstanding RVTs, noted that Marlene’s veins were very small, and therefore not an ideal candidate for a bypass at this time.  The decision was made to proceed with an endovascular option for her and she subsequently underwent a stent placement, the first of what would be three in the coming years, to restore the blood flow in her leg.

Life went on until this past year when Marlene says, “While on a long-planned trip to visit my daughter in Germany, I realized that I was no longer able to even enjoy basic sightseeing activities and felt like I was slowing everyone down.  The stent procedures were no longer giving me lasting results.”

There was constant pain.  Marlene described that she could not walk more than a few steps without her leg feeling extremely tight, she lost almost all circulation to her feet and toes so those were painful and swollen and had to sleep with her leg hanging down off the bed for any relief, so she was barely getting any sleep.

After a visit back to Dr. Hoenig it was determined further intervention was needed and on July 27th Marlene underwent a femoropopliteal bypass with an artificial graft to circumvent the narrowed artery in her right leg.  This process illustrates why board-certified vascular surgeons should be the only ones treating peripheral artery disease; with so many “tools in the toolbox,” all options remain on the table as opposed to other specialties which do not have the surgical option available and would have continued to attempt temporary endovascular “fixes.”

Marlene said she felt relief within a week after the procedure and returned confidently to her normal activities about 2 weeks post-op. She said, “I still have some discomfort and there is a section near my ankle where I have a little numbness which I am hopeful will come back to normal.”

She is so happy she decided to have this procedure and said, “I’ve been able to take walks, climb stairs and ride my road bike without pain.  I was even able to dance at my great nephew’s wedding.”

Marlene is grateful to the TVCG team and added “Dr. Hoenig and his entire staff have been so supportive, and I would highly recommend his office and expertise to get you back to doing everyday movement if you are having difficulties.”

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

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


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.

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:

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?


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.”