Choosing an endocrine surgeon

If you are in an established practice, more than likely you have a relationship with one or more endocrine surgeons in your community. However, if you are new to practice or have relocated, it can be difficult to choose a surgeon for your patients.

Many surgeons express interest in performing endocrine surgery. They are eager for us to send our patients to them. The problem is, just as with any profession, some surgeons are better than others. An excellent resource is other endocrinologists in your community. They know who the best endocrine surgeons in your area are and will have no problem sharing their experience.

We desire the lowest rate of complications possible. The outcome of surgery is related to the number of procedures performed. Thus, an important factor to consider is volume of cases.

However, choosing a surgeon is more than only deciding who is the most technically skilled. There are many experienced surgeons who are not as capable in the humanistic side of medicine. To be sure, if it was an emergency and I had to choose between someone who was skilled but lacked bedside manner vs. someone who was nice but not as competent, I would choose the former over the latter. Ideally, however, the decision should not be between these two scenarios. Consultants must be both skilled and have good bedside manner. If patients are not treated well, it reflects poorly on those who sent them there.

Sometimes a new surgeon asks for your referrals. This is difficult. If you have had success with other surgeons, you may be hesitant to refer to someone else without reason. If you were the patient, would you want to be the first sent to a new surgeon to try him/her out? I doubt it.

On the other hand, surgeons retire, get sick or move away. I use more than one surgeon to avoid having my eggs in one basket. My advice to surgeons new to a community interested in referrals is to let your local endocrinologists know. Then, instead of waiting for endocrinologists to send patients to you, be proactive. Send them patients with thyroid nodules for fine-needle aspiration, patients with hypercalcemia prior to parathyroidectomy, and patients with thyroid cancer for long-term follow-up. If you are skilled and eager to work with endocrinologists, they will be interested in working with you.

I always ask the following question: Would I feel comfortable having the particular surgeon perform the procedure on me or a family member? The answer must be yes. Our patients deserve no less.

Richmond et al. The American Surgeon. 2007;73:332-336.