How to Choose the Best Thyroid Surgeonby Mary Shomon Patient Advocate
Thyroid surgery — known as thyroidectomy — is performed as a treatment for thyroid cancer, and for some cases of goiter, thyroid nodules, and hyperthyroidism/Graves’ disease.
It is important to choose an experienced surgeon. Find out why, and how to find a qualified surgeon with expertise in thyroid surgery.
An experienced thyroid surgeon reduces your risk of complications
According to the American Thyroid Association, having an experienced thyroid surgeon dramatically reduces your risk of complications after thyroid surgery. These complications can include post-operative bleeding, temporary or permanent damage to your laryngeal nerve and voice, and/or temporary or permanent hypoparathyroidism (which can cause low calcium levels, and require calcium and vitamin D supplementation).
An inexperienced thyroid surgeon significantly raises your risk of complications
Speaking to EndocrineWeb, Julie Ann Sosa, M.D., senior author of a study on surgical experience, and chief of endocrine surgery/leader of the Endocrine Neoplasia Diseases Group at Duke University, said:
"If your doctor does, on average, just one total thyroidectomy a year, you have an 87 percent increase in the odds of sustaining a thyroid complication from your surgery compared to a patient who undergoes a thyroidectomy from a high-volume surgeon."
The risks of thyroid surgery are related to a surgeon’s experience
According to Dr. Sosa’s research, the increased risks are:
- 68 percent for surgeons performing two to five thyroid surgeries per year
- 42 percent for six to 10 thyroid surgeries per year
- 22 percent for 11 to 15 thyroid surgeries per year
- 10 percent for 16 to 20 thyroid surgeries per year
- 3 percent for 21 to 25 thyroid surgeries per year
Working with a high-volume surgeon may shorten your hospital stay
According to Dr. Sosa’s research, patients with a low-volume surgeon have twice as long a hospital stay for recuperation after thyroid surgery, compared to those who work with a high-volume surgeon.
How do you define an experienced, high-volume thyroid surgeon?
Dr. Sosa’s research has shown that a selecting a surgeon who performs a minimum of 26 thyroid surgeries per year dramatically reduces the risk of complications after thyroid surgery.
Columbia University’s New York Thyroid Center recommends you work with a surgeon who performs a minimum of 50 thyroid and parathyroid surgeries per year. Professionals there also recommend only using thyroid surgeons classified as “experienced” (500+ thyroid surgeries performed to date) or “expert” (1,000+ surgeries each year).
Experienced, high-volume thyroid surgeons are not easy to find
It’s estimated that more than 130,000 thyroidectomies are performed each year in the United States. According to Dr. Sosa, more than half of the 4,600 surgeons she surveyed only perform one thyroidectomy a year. This means, according to Dr. Sosa, that more than 80 percent of thyroid surgeries are performed by low-volume thyroid surgeons.
How to find an experienced thyroid surgeon
Some resources where you can start your search include:
- The American Association of Endocrine Surgeons website and their “Find a Member” database
- The American Thyroid Association practitioner database (search on “Endocrine Surgeon”)
- The American Association of Clinical Endocrinologists practitioner database (search on “Surgery”)
Questions to ask before selecting a surgeon
There are two key questions to help identify a qualified thyroid surgeon:
- Ask the surgeon how many thyroid surgeries he or she performs each year, and how many performed in total.
- Ask the surgeon about his or her personal complication rate (not a generic complication rate quoted from medical literature).
According to Columbia’s New York Thyroid Center: “An expert will expect to be asked these questions and should not get offended by them.”