Phlebologist in Latviawhat the state funds, what it does not, and the vein procedures available

A phlebologist diagnoses vascular disease and plans treatment for venous and lymphatic insufficiency and leg ulcers, and also treats vascular problems that are cosmetically troubling.

• Varicose vein disease
• Chronic venous insufficiency
• Venous leg ulcers
• Leg swelling and lymphatic insufficiency
• Thread veins and other cosmetic vascular problems
• Assessment after a previous thrombosis

The ARS medical centre notes that causes vary: an inherited tendency to weak vein walls, a sedentary lifestyle, work in occupations requiring long periods of standing, and heavy physical strain.

This is the key financial boundary in this field.

In practice this means laser, radiofrequency and glue methods are usually private, while classic surgery for complications may be state-funded.

For surgery in hospital a specialist referral is needed, and the patient applies to a provider delivering the service. The National Health Service gives as examples Rīga East University Hospital, Ziemeļkurzeme Regional Hospital, Rēzekne Hospital, the Balvi and Gulbene hospital association, and Preiļi Hospital.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• A certificate in a base specialty, most often surgery or vascular surgery.
• Phlebology in Latvia is a narrower field of practice, and some specialists appear in the register as both phlebologists and vascular surgeons.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Method. If you want endovenous laser or glue treatment, expect it to be private.
• State funding. If you have varicose vein complications, discuss with the doctor whether your case qualifies for state-funded classic surgery.
• Ultrasound. Venous Doppler is the basic investigation, so a provider that performs it on site is more convenient.
• Combined methods. Some clinics state that laser surgery is often combined with microsurgical phlebectomy.
• Regional access. State-funded vein surgery is also performed at several regional hospitals.

• The doctor takes a history covering the nature of your work, lifestyle, physical activity, habits and family history.
• Before the appointment it is worth recalling any leg injuries or physical damage.
• Standing, the doctor assesses the size and location of varicose veins, ankle swelling and skin appearance, and measures leg circumference. Lying down, they assess skin condition, swelling and any ulcers.
• Veselības centrs 4 states that physical activity is recommended from the day after surgery, since movement speeds blood flow in the deep veins and reduces clot risk.
• At the same time, heavy exertion and lifting should be avoided for the first month.

In the public system, with a referral, a specialist visit costs 4.00 EUR, inpatient treatment 10.00 EUR per day from day two, and up to 31.00 EUR for the operation.

• Patient co-payment for a specialist visitPrice EUR: 4.00Source: NVD
• Classic vein surgery in hospital for complicationsPrice EUR: state-funded with co-paymentSource: NVD
• Endovenous laser, radiofrequency or glue procedurePrice EUR: per clinic price listSource: Cēsu klīnika
• Foam sclerotherapyPrice EUR: per clinic price listSource: Cēsu klīnika
• Compression stockingsPrice EUR: per price listSource: ARS

The closest sector body is the association "Latvijas asinsvadu ķirurgu biedrība" (Latvian Society of Vascular Surgeons), registration number 40008049852, contact Dainis Krieviņš.

Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.