Suppose your endocrinologist has advised you to consult an endocrine surgeon based on your diagnosis. What do you do next?
You may already be feeling a range of difficult emotions. Now, selecting a new and vital part of your medical team can pile on yet additional stressors.
The aim of this post is to help you navigate your decision, by pointing out some of the important criteria involved in choosing a surgeon. Hopefully this results in a more actionable list of considerations.
It is important to remember to look for the surgeon who is right for YOU.
How Do I Find the Right Surgeon For Me?
There are four main areas to explore as you seek the right surgeon. They are:
- Experience and Competence: You want a surgeon with a proven successful track record. There are several ways to confirm this, as discussed below.
- Communication Style: Surgeons differ in their interpersonal styles. If you prefer to have a dialogue with your surgeon and weigh various options together, then some surgeons will be a better fit than others.
- Institutional Affiliations & Resources: Some surgeons are affiliated with larger institutions. A surgeon who is affiliated with a credible institution is likely to adhere to certain high standards. Some institutions also come with the backup resources and support of a hospital, as opposed to a private practice.
- Practical & Financial Concerns: There are several things you have a right to know in advance. These include insurance coverage for your surgery, the location and accessibility of the facility where you will have your operation, and any scheduling details pre- and post- surgery.
Category One: Experience and Competence
As with most types of surgery, the chance of having a successful and safe endocrine operation increases with the experience of the surgeon. In particular, thyroid surgery is a highly specialized field which requires significant experience to master.
There are two types of surgeons who deal with endocrine disease:
- Endocrine Surgeons: these are surgeons who have specialized in conditions of the thyroid, parathyroid, and adrenal glands. Most endocrine surgeries are performed by endocrine surgeons.
- Head & Neck Surgeons: these are surgeons who have specialized in diseases affecting the ear, nose, and throat (they are also called ENT surgeons for that reason). Some treat thyroid and parathyroid disease, but not all head & neck surgeons are qualified to treat endocrine disorders.
It is therefore important that you inquire about the surgeon's specific experience level, which is best measured by the number of procedures they have done.
Do not be afraid to ask your potential surgeon:
- How many thyroid, parathyroid, or adrenal operations do you perform each year?
- What is your personal complication rate?
An expert will expect to be asked these questions and should not get offended by them.
Research has shown that a surgeon should do more than 50 thyroid and parathyroid operations a year to be considered an expert. For adrenal operations, the expertise minimum cutoff is 20 per year.
A surgeon’s TOTAL number of operations also matters. A surgeon who has performed more than 1,000 operations can be considered an expert. By contrast, a surgeon who has performed fewer than 200 operations is inexperienced.
If possible, look for an experienced surgeon who has performed at least 500 operations of this kind.
Category Two: Communication Style
Surgeons are people. People all differ in how they interact. Among surgeons, there is a wide variety of doctor-to-patient communication styles. Ask yourself: “What kind of dialogue do I want with my surgeon?”
If, for example, you prefer to discuss your treatment in depth, you have every right to state that openly. If you sense that a surgeon is impatient or unwilling to answer your questions thoroughly, then feel assured there is probably a better fit elsewhere.
That is not to say that you need to discuss every detail of your operation. Perhaps you are someone who finds it most reassuring to leave the intricacies of each medical decision to the surgeon’s expertise and only speak about things at a high level. Ultimately, the right fit depends on what makes you feel most comfortable with your treatment.
Category Three: Institutional Affiliations & Resources
Medicine is constantly improving, and you want a surgeon who keeps up with the latest advances in care. To increase the chances of that, consider a surgeon who is affiliated with a research hospital or academic medical center. A research hospital is one that also provides training to younger doctors and scientific innovation in addition to clinical care. A surgeon who is affiliated with a reputable institution is likely to be held to a high standard of care.
A second benefit of this affiliation is access to the resources of a large institution with specialists across multiple fields and top-of-the-line technology. This makes it more likely that your surgeon will be working as part of a larger team, so you get more comprehensive care. And if an emergency occurs during a surgery or there is a complication afterwards, there is a staff and the necessary equipment to deal with it right away. On the other hand, an off-site ambulatory clinic or private practice may not offer that guarantee.
Category 4: Practical & Financial Concerns
Finally, there is an important ― and completely non-medical ― aspect to choosing a surgeon. Every big decision involves some measure of practicality. The most obviously relevant concern in regard to surgery is cost.
If you have health insurance, you have a right to confirm in advance the types of fees for which you will be responsible after your treatment. (If you don’t yet have health insurance, it is beyond wise to immediately explore your coverage options.)
Call your insurance representatives to ask which surgeons and which services are covered under your plan. Have them specify what proportion of cost your plan covers, and whether you have a deductible or out-of-pocket maximum.
Contact your surgeon’s office, as well, and confirm that they accept your insurance. Ask about any services that you may not at first anticipate, such as an anesthesiologist. Try to cross-reference between the surgeon’s office and the health insurance agent, until you feel satisfied. It is within your right not to get stuck with a surprise bill.
After considering cost, make a list of all other practical concerns.
- The location and accessibility of a particular hospital may be relevant, for instance, if they necessitate far travel.
- The surgeon’s schedule and availability may offer only an unacceptable time window.
- Recuperation time may call for time off work, as well as assistance from a caregiver.
Whether these elements factor into your decision depends entirely on your circumstances. Simply, be mindful of related expenses and planning required by an operation.
There is no reason to ever accept feeling pressured or neglected by your healthcare team members. Though the process can feel overwhelming and intimidating, the purpose of an operation is to improve your health. Your healthcare team exists to help you.
- Meet our Endocrine Surgeons
- Columbia Thyroid Center
- Columbia Parathyroid Center
- Columbia Adrenal Center
- What to Expect at a Consultation
- How to Prepare for a Consultation
- What to Expect After a Consultation
- What to Expect – Your Surgery
- How to Prepare for an Operation
Call us at (212) 305-0444 or reach us through our online appointment form.