19/04/2013 11:38 BST | Updated 19/06/2013 06:12 BST

Who Should You Trust to Treat Your Varicose Veins?

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I recently managed to annoy vascular surgeons from around the world with an article I wrote for a magazine. In the article I suggested that patients should seek treatment for varicose veins from a doctor who is both actively involved in varicose veins research and who also performs varicose vein surgery five days a week.

Interestingly, no one has argued against the idea of seeking out a specialist who is active in the research of varicose veins. Presumably this is because it is evident that those involved in such research, are likely to have a deeper understanding of the underlying problem and offer the most up-to-date techniques.

It is the second part of my article that seems to have raised objections from vascular surgeons who spend most the time treating arteries and only between half a day to one and half days a week treating varicose veins.

The term "vascular surgeon" would seem to imply a surgeon who specialises in treating blood vessels leading people to believe they are experts in varicose veins also.

However, for those of us in the medical world, we are aware that the vast majority of vascular surgeons are really only experts in arterial surgery which carries a completely different set of skills from those required to treat varicose veins.

A modern day varicose vein expert should have a deep understanding of venous physiology and the new duplex ultrasound scanning device, good hand-eye co-ordination skills (particularly when carrying out new and advanced treatments under ultrasound), good patient communication skills and finally the backup of a specialised team to help in providing care for patients post-op.

Varicose vein surgery, as with any surgical speciality, is basically a practical procedure that requires an understanding of the underlying processes. Therefore in the purest sense, it is really no different from virtually any other area of human activity. For example, for a plumber to be able to do their job properly they need to have a full understanding of the system of pipes and valves and how they should be working.

Over the last few years, there has been increasing interest in the work of Dr K Anders Ericsson, a psychologist who developed the concept that it takes 10,000 hours of practice to become an expert in a field. Although the number of hours of practice may be open to dispute, what has become very clear is that the more hours of practice someone puts into something, the more expert they become in it and the more likely they are to succeed.

Putting the work of Dr Ericsson together with my own insiders understanding of medicine, it is clear that the title of a doctor has little relevance to their ability to perform excellent varicose vein surgery. What is important is their training and how often they practice their trade.

The venous world is changing at a huge pace, with new techniques and devices to treat varicose veins and other venous conditions appearing all of the time. No matter how good someone feels they are, if they do not have the experience of treating patients with the different types of varicose veins they will not be able to provide a truly specialist service and are less likely to get as good results for their patients as those that do.