FVLD Supporter Stories: Bruce Fearon

Meet Bruce Fearon, MD, a long-time AVLS member and FVLD donor. Originally a family medicine specialist, he began his journey into venous medicine at the prompting of family members who were suffering from venous disease. At a sclerotherapy educational session, Dr. Robert Murray, an AVLS member, inspired Dr. Fearon to not just treat the visual veins but to look for the source of the reflux and treat the underlying problem. “If I can’t do it right, I don’t want to do it,” said Dr. Fearon.

Dr. Fearon worked for a year and a half as a family doctor and vein doctor simultaneously, as he was skeptical about making a living practicing vein medicine alone. But as venous patients continued to come in daily, he made the transition to full-time vein specialist.

Excitedly, he was able to get in on the ground floor of a new medical specialty, as the American Medical Association had just recognized phlebology. Dr. Fearon leapt into vein practice full-time and has continued to maintain his certifications. He was in the first class of ABVLM diplomates, which proved helpful in establishing his credibility to practice in his area, particularly among his colleagues who knew him as a family doctor.

Dr. Fearon began his education efforts focused on primary care providers in his community. He would provide education on different stages of vein disease and demonstrating the effectiveness of venous medicine in treating skin changes and ulcerations. His physician liaison set up lunch-and-learns and evening open house events, where healthcare providers can learn about blood flow, watch live demonstrations, and understand treatment options.  

“The point I’d like to emphasize here is having been a family doctor for 12 years on the front line, even though I learned a little bit about veins before pursuing it as specialty, I was missing it, misdiagnosing it, and doing all the wrong things I learned in residency, not realizing that most vein problems involve the superficial system,” said Dr. Fearon.

As Dr. Fearon goes out to teach among the members of his community, he explains this sentiment to them, helping them realize how there’s been a gap between what they were looking for and the problem of venous disease. For 13 years, Dr. Fearon has been out in the community educating primary care and specialists in his area. He believes that getting out and educating those on the frontlines of medicine is a good way to build one’s practice, and those roots will serve them well. 

“The problem with residency programs is that they don’t know what they don’t know,” said Dr. Fearon.

In 2019, Dr. Fearon was faced with the need to hire a new physician. He found it was difficult to find anyone who wanted to switch careers and he was trying to figure out how to influence a younger doctor or other future healthcare worker to entertain venous medicine. He needed to get exposure to residents. Dr. Fearon believes that until you get out there and show residents what they have been seeing and give them an explanation for atrophie blanche, stasis dermatitis, and/or non-healing “bug bites” which are really venous ulcers, they will continue to live in that dark area. There should be a drive to get out there and enlighten them. Dr. Fearon’s goal is to provide them with an introduction. 

Dr. Fearon invited a resident out from a local program, gave them a tour of his practice, and taught them some principles. His preceptorship program grew out of this initial touchpoint. Fast forward to present day, Dr. Fearon just completed his first month of a preceptorship with his practice's first family medicine resident, and they have three more lined up. In August, he gave a presentation to other local family medicine residents with the hopes of educating staff as well as the residents. He has reconnected with his Alma Mater to see if they can connect on a preceptorship as well and is also currently reaching out to mid-level schools and programs to secure preceptorship rotations at his clinic. 

Dr. Fearon was compelled to act in creating preceptorships for medical residents after benefiting from all the hard work that the AVLS has done throughout the decades. He is transparent about his initial hesitancy to get involved in this capacity because he migrated from Family Medicine and was unsure of how he could be a benefit to the residents, since he isn’t an academic. Dr. Fearon has donated money to the FVLD throughout the years, with the belief that if you’ve been practicing venous and lymphatic medicine for a long time and you’ve benefitted from the specialty, you should feel an obligation to give back to your community and educate the next generation of healthcare workers. 

The program reaches more than just medical residents, however. An ultrasound technician at Dr. Fearon's practice is an instructor at one of the local medical schools, and for the past year they have had four to five ultrasound students complete a 10-week rotation with them as part of educating the ultrasound techs on superficial vein disease. 

Preceptorship students get a wealth of experience with scanning and learning the anatomy. As a subscriber of the AVLS ePass, he granted rotating medical students access to lectures from past Annual Congresses to supplement their hands-on training with didactic lectures. 

As Dr. Fearon continued to work on fine-tuning his preceptorship program, he realized the need to create a turnkey preceptorship model that all AVLS members can use. His ideas for this model include creating pre-and post-rotation quizzes for the residents so that they can see how they’ve gained knowledge of anatomy and basic concepts, watching various AVLS ePass lectures, and inviting residents who complete a preceptorship to attend an AVLS Annual Congress and help grow the field.

Recently, Dr. Fearon hired an ultrasound student that went through his preceptorship program. An added benefit of recruiting students for preceptorships is that he gets first dibs on the students about to graduate. He recalls past meetings where doctors have expressed frustration of how hard it is to find new employees. He believes that if you wait until students are graduated, it is hard to track them down because they might have already accepted other jobs. The trick is to get exposed to them earlier – even if a student doesn’t come to work for them in the end, they’ll see the doctor as a source of authority improving their network and allowing opportunities for referrals. Moreover, preceptorships provide an altruistic opportunity to  give back to the field. 

Overall, Dr. Fearon is content with his accomplishments as a venous and lymphatic specialist and wants to give back. As his daughter pursues medical school, he really wants the future vein specialist to be adept at a number of things. The field of venous medicine is very diverse as practitioners have unique focuses from superficial to deep and pelvic veins. In the future, he would like to see vein specialists to be competent in both deep and superficial veins. Dr. Fearon agrees that venous and lymphatic medicine should be a sub-specialty with the American Board of Medical Specialties (ABMS) and supports AVLS development of fellowship programs to get recognized as an independent specialty. 

Dr. Fearon has observed some AVLS members working extremely hard in their practice, but without the opportunity to do much teaching. He believes that a smooth transition and introduction to a preceptorship program could be achieved by completing rotations and other introductory material, paving the way to building fellowship programs. The preceptorship Dr. Fearon is currently conceiving is an introduction to vein disease – a transition and introduction to building Fellowship programs. Eventually, he anticipates there will be a need for level 2 and level 3 preceptorships, where AVLS members can use the opportunity to expand their skillsets.

“It would be a great way for AVLS members to get in on the ground floor of educating our future healthcare workers,” said Dr. Fearon

There is a sign in Dr. Fearon's home that reads, “We may not have it all together, but together we have it all.” While developing preceptorships, he reflected on osteopath students, which spend part of their time at one place learning one thing, another part of the time learning other things elsewhere, and together everything becomes pieced together. While traditionally physicians have received all their training in one place, we might have to accept that fellowships and even residencies in the future may require rotating between locations and physicians to learn different things, creating a network rather than a one-place institution. As the students rotate around and spend time doing different things, it helps them choose what makes sense to them and create connections with those people. 

“We all have to piece together our own network wherever we are, and ultimately, we want what’s best for the patient,” said Dr. Fearon.  If I lose some work in the process that’s fine, but from the start you can create a relationship.” 

Dr. Fearon thinks doctors would find it very enlightening to open their clinics up for 10-12 half-day educational sessions. Students might first listen to a lecture, followed by observations in the treatment room; another lecture during the following visit followed by observation of chemical ablations; then a lecture on the basics of ultrasound and how duplex ultrasound is used to study and evaluate deep and superficial veins and do vein mapping, followed by shadowing the ultrasound technologists and observing vein mapping. 

“I am of the belief that if you pay things forward, it tends to come back to you,” said Dr. Fearon. “I believe that when you are passionate about something and interested in helping people, the physicians and various groups I’ve spoken to pick up on that genuineness. As you pay into the system, it’s not going to rob you of business, most of these young residents aren’t going to be your huge competitor a year out from then. Most of them are strapped with financial debt and if anything, they would probably approach you to help them out and get them going. It is a matter of recognizing that you have more to offer than you think, just because you migrated from another field. Again, I am not an adjunct professor anywhere, just a family doctor. I do think you can, and you will gain in confidence as you teach.” 

Any AVLS member can implement a preceptorship program. Dr. Fearon’s goal is to create something easy, to make this something anyone can do. A preceptorship program is a model of introductory education for not just residents but also ultrasound technicians, mid-level providers, and other allied healthcare professionals. 

“I’m in the final ten or so years of my career where I’m trying to give back, make this a better area of medicine, and get it recognized,” said Dr. Fearon. “I very much want future vein specialists to be complete vein specialists. I want my daughter to be able to benefit from these Fellowship programs down the road. AVLS has done a great job working with advocacy and healthcare policy, but nobody has thought about it from a grassroot effort.  Thinking about it from a grassroot effort will enhance the awareness of the specialty.”