Which Patient With DVT or PE to Refer to a Specialist?

Stephan Moll, MD writes…  Not every patient with DVT or PE needs the same type of physician.  The best combination for a patient to have may be (a) a primary care provider, (b)  a health care professional in a formal Warfarin Clinic and (c) a physician with special expertise in thrombosis, and a primary care provider,  for a one time consultative visit or once per year visit.  However, the question which patient to refer to a specialist should really be determined by the level of comfort and expertise of the primary care provider to manage the various aspects of DVT and PE.   A general concept as to which patients to consider for a referral to a  specialized Thrombosis Clinic is submitted here.  

RESOURCES

•  Coumadin Clinics:  A list of Coumadin Clinics in the U.S. can be found here.
• Comprehensive Thrombosis Centers: Thrombosis Clinics may be part of a Thrombosis and Hemostasis Center or a “Center for Bleeding and Clotting Disorders”.  A partial list of such centers in the U.S. can be found here. 
• Hematologists specialized in thrombosis and thrombophilia care:  The American Society of Hematology offers an index of physicians who have a clinical interest in treating patients with blood clots and clotting disorders.  The index can be found here.   To use this index, select a location and, under the drop-down box for ‘Clinical Interests’, select “Thrombosis and Hemostasis/Blood Clotting”.
• A variety of other specialists – Vascular Surgeons, Cardiologists, Pulmonologists or General Internist take an interest in and have special expertise in venous thromboembolism.  Unfortunately, there is no one web-based information system to find a thrombosis specialist of whatever specialty. Such a system is clearly needed, to be able to refer patients, wherever they are, to a physician with expert knowledge  in thrombosis and thrombophilia.  Criteria need to be developed as to what classifies and defines a thrombosis practice/center as a “Thrombosis Practice/Center of Excellence”, and a web-based tool needs to be put in place so that patients and health care professionals can find that information.

For patients:  This same topic, written more in detail for patients, can be found here.

Disclosures:  I have no financial conflict of interest.  I am a hematologist and work in a comprehensive Thrombosis Clinic.

Last updated: May 16th, 2012