At the Vascular Institute of Michigan, which my partner and I
opened in 2016, we're doing twice as many procedures as we were
able to do in the hospital, and doing most of them on an outpatient
basis. We practice all facets of vascular surgery, including lower
extremity angiograms and venograms, laser ablation, micro phlebec-
tomy, dialysis access and maintenance, catheter placement and medi-
port insertion. The only procedures we always do in the hospital are
carotid stenting and aortic aneurysm endovascular repair (EVAR).
Along with being a fantastic arrangement for us, patient satisfaction
has greatly increased as a result. Of course, we didn't just lease a
building, haul in some equipment, throw open the doors and start
treating patients. Planning was essential.
We actually started from scratch with a building that had to be gut-
ted and rebuilt from the ground up. But before we opened, my partner
and I made several site visits all over the country to other facilities
that specialize in vascular procedures. We had a vision, but we want-
ed to make sure we knew what pitfalls to watch out for. We learned a
lot.
1
The right space. If all you're doing is pain intervention, you
don't need much space. You'll be using either radiofrequency
ablation or laser ablation, and both machines are very small.
Nor will you need a lot of room for personnel, because those proce-
dures require only an anesthesia provider and a nurse, in addition to
the surgeon.
But if you're doing procedures that require more sophisticated imag-
ing and C-arms — such as lower extremity angiograms and interven-
tions — you're talking about bigger tables, bigger shelves for equip-
ment, more wires and more people. In short, you're going to need a
sizable room.
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