Abstract
A day in the life of a vascular medicine specialist
J Blake Iceton, MS, MD
Vascular medicine (VM) is a specialized field dedicated to the diagnosis and treatment of conditions affecting the circulatory system. Physicians in this field manage a wide range of diseases, including peripheral artery disease (PAD), venous thromboembolism (VTE), chronic venous and lymphatic disease, carotid stenosis, and aortic aneurysms among others. We employ noninvasive vascular testing, patient education, medical therapy, and minimally invasive procedures to reduce risk factors, optimize peripheral perfusion, and prevent complications such as ulcers, amputations, and life-threatening embolisms. VM specialists interact with a wide variety of other specialists and come from a wide variety of backgrounds themselves. As a VM fellow, I have been fortunate to closely follow patients alongside specialists in VM, vascular surgery, cardiology, interventional radiology, hematology, rheumatology, dermatology, infectious disease, endocrinology, and plastic surgery. Within cardiology, VM specialists work with general cardiology, interventional cardiology, preventive cardiology, structural cardiology, and cardiovascular genetics.
This article is intended to describe a day in the life of a VM specialist and highlight the value the Society for Vascular Medicine (SVM) provides. The major caveat in doing so is the huge variation in practice depending on any one physician’s background, area of interest within VM, and the needs of their organization or community. However, across this variation of settings lies a unifying theme: the responsibility and privilege of extensive relationship development with patients and other providers.
Like most physicians, an inpatient day typically starts early with review of overnight consults, critical lab results, and other significant events. Then, it is time for further targeted time for further targeted chart review before heading to morning rounds. The VM physician often leads a multidisciplinary team, including residents, fellows, and nurse practitioners, to discuss patient presentations, evaluate patients at the bedside, and formulate treatment plans, while incorporating teaching points. After rounds, the VM specialist may see additional patients not on the teaching service, check back on any particularly sick patients, and reach out directly to other specialists to discuss complex cases.
Around noon, there may be time to attend an SVM committee meeting online, briefly work on a grant proposal, or catch up on the latest issue of Vascular Medicine. Soon, calls will be incoming as branch points in management plans discussed earlier are reached. For example, new consults may be requested for a pregnant patient with acute deep vein thrombosis (DVT), headache and jaw pain with suspected vasculitis, or anticoagulation management for a patient on apixaban with recent DVT who is having melena. Vascular lab studies need to be read before the day is done, and topics for an afternoon chalk talk need to be considered. In addition, the pulmonary embolism (PE) response team (PERT) may be activated at any point, requiring urgent evaluation of an unstable patient. PERT facilitates a multidisciplinary discussion to provide improved outcomes for patients, which can add a course-altering procedure for the interventionalists among us and can establish a relationship with the patient to follow up for post-PE care. After what feels like the blink of an eye many days, the sun is setting and a final review of the patient list with updated results is completed before heading home and hoping for a quiet night from the pager.
In the outpatient setting, a VM specialist’s day may be more predictable, but a diverse array of responsibilities remains. The day may start with patient evaluations for persistent bilateral leg swelling, suspicion of fibromuscular dysplasia (FMD) in a patient recently discharged from hospitalization with spontaneous coronary artery dissection (SCAD), and a nonhealing wound requiring debridement and diagnosis of etiology. Interspersed are follow ups with patients who have been coming to the clinic for years; for example, patients with prior carotid endarterectomy for symptomatic carotid artery stenosis, PAD post revascularization and toe amputation, postthrombotic syndrome on apixaban, or a slowly enlarging abdominal aortic aneurysm for monitoring. Discussion of any new symptoms and careful review of medications and risk factor profiles are necessary. Review of vascular lab studies with each patient provides timely information on progression of disease and an opportunity to clarify any questionable findings with sonographers on site.
In addition to patient visits, many VM providers perform interventions in clinic, including wound debridement, endovenous ablation, sclerotherapy, and supervised exercise therapy, or even catheterizations (for those with additional fellowship training). Collaboration with consistent medical assistants, nurses, and vascular sonographers and other radiology techs creates an efficient team for completing these procedures safely and with increased patient satisfaction. On procedure days, time between patients is often spent communicating with other providers, squeezing in additional patient visits, updating patient registries, or connecting patients with cutting-edge clinical trials.
Whether in the inpatient or outpatient setting, vascular medicine is inherently multidisciplinary, requiring seamless collaboration with other specialties to ensure optimal patient outcomes. 1 We frequently work with vascular surgeons and interventionalists for patients requiring bypass surgery or endovascular intervention, cardiologists for those with concomitant coronary artery or structural heart disease, hematologists for complex clotting disorders, and rheumatologists for vasculitides (Figure 1). Close coordination with infectious disease specialists, wound care specialists, and rehabilitation teams helps patients avoid complications such as infections or amputations. Attending annual conferences with multidisciplinary representation such as SVM’s Vascular Scientific Sessions (VSS) provides the opportunity to meet vascular medicine specialists from other practices across the country as well as specialists in other fields, build relationships, and learn how to best incorporate their expertise in day-to-day management of patients with vascular disease. The multidisciplinary nature of VM also yields a fertile ground for research with a wide range of opportunities for basic science and clinical research as well as drug and product development.
Diversity of origins in vascular medicine: a cardiologist (Nigel Santos), wound care nurse (Judy Lau), vascular sonographer turned internist (Blake Iceton), and plastic surgeon (Eri Fukaya), each now specializing in vascular medicine.
Even more so than collaboration with outside specialists, building lasting relationships with patients yields the highest rewards in caring for our patients. Many require long-term monitoring and lifestyle interventions with medical optimization regardless of whether they undergo procedures. Counseling patients on smoking cessation, exercise, weight management, and medication adherence is a fundamental part of their care. Spending time to educate patients on their conditions in turn engenders buy-in to their prescribed activities. The Vascular Disease Patient Information Pages, published in the Vascular Medicine journal and curated on the SVM website, are an incredible resource that is freely available to all. By fostering trust and continuity of care, VM specialists empower patients to take an active role in their health, ultimately improving outcomes and quality of life.
In conclusion, VM is a dynamic and rewarding specialty that bridges acute and chronic care, blending medical expertise with procedural skills and patient-centered management. Whether in the hospital or clinic, we as VM specialists develop unique provider–patient and provider–provider relationships that allow us to play a pivotal role in maintaining vascular health and preventing life-altering complications.
Highlights from the 2025 SVM Fellows and Advanced Practice Provider course
Stanislav Henkin, MD, FSVM, Daniella Kadian-Dodov, MD, FSVM, and Danielle Vlazny, PA-C, MS, FSVM
The 11th annual SVM Fellows and Advanced Practice Provider (APP) course was held in March in Atlanta, Georgia. Course leadership included Drs Daniella Kadian-Dodov (Chair) and Stanislav Henkin (Co-Chair) for the Fellows course and Danielle Vlazny (Chair) for the APP course.
The 2025 course was fortunate to have world-class faculty who took attendees on a deep dive into the foundations of vascular medicine. Highlights of the course included a newly developed multidisciplinary session on aortic disease, Imaging Cases over Cocktails, a Point of Care Ultrasound (POCUS) Workshop, Tabletop Learning with Industry, and meal-time symposia by industry supporters (listed below). The course attracted multispecialty participation from vascular medicine, vascular surgery, general cardiology, and interventional cardiology trainees and APPs. The faculty included physicians and APPs from across the country, resulting in rich discussion and opportunities for networking throughout the weekend. The didactic schedule encompassed medical management and intervention for atherosclerotic and nonatherosclerotic arterial disease, acute and chronic venous disease, and lymphatic disease. Photos from the event can be seen in Figures 2–4. SVM thanks all of the sponsors who supported this event (Table 1).
Society for Vascular Medicine leadership for the 2025 Fellows and Advanced Practice Provider (APP) course. (
2025 Society for Vascular Medicine Michael R Jaff, DO, MSVM, Leadership Institute Fellows pictured with Chair and Co-Chair of the Jaff Leadership Institute, Drs Naomi Hamburg (right) and Alexandra Solomon (left), respectively.
Attendees participated in the interactive Point of Care Ultrasound (POCUS) Workshop during the 2025 Society for Vascular Medicine Fellows and Advanced Practice Provider course, led by Chair, Dr Gaurav Parmar (bottom).
Sponsors of the 2025 SVM Fellows and APP Course.
The 12th annual Fellows/APP course will be held in Chicago, March 21–22, 2026. Please stay tuned for more information and spread the word to your trainees and APPs!
Please see below for some examples of the feedback we received from our fellow and APP attendees:
Excellent line up of faculty presentations and hands-on experience. Great to practice on devices!
Excellent session, loved the variety of talks; speakers and topics were engaging and relevant.
Overall amazing topics and learned so much about the field and career options.
Very interesting, and I love the small group setting.
Great discussions and points of view on difficult treatment methods.
Very informative; we will definitely have a more patient-directed anticoagulation management.
Cutting-edge presentations; really enjoyed learning about new research.
Excellent course; I learned a lot and made important connections.
Very informative, especially coming from a cardiology background.
