Current Trainee and Workforce Patterns for Thyroid and Parathyroid Surgery in the United States

Area of Science:

• Surgery
• Otolaryngology
• General Surgery

Background:

• Thyroid and parathyroid surgery are procedures performed by both general surgeons and otolaryngologists.
• Understanding the distribution of these procedures between specialties is crucial for targeted interventions.

Purpose of the Study:

• To determine the proportion of thyroid and parathyroid surgeries performed by general surgeons versus otolaryngologists.
• To provide data for directing research, education, and quality improvement initiatives in endocrine surgery.

Main Methods:

• Analysis of Marketscan data (2010-2016) for privately insured patients undergoing thyroid and parathyroid surgery.
• Examination of trainee case logs for general surgery and otolaryngology residents and fellows.
• Calculation of summary statistics and trend/difference tests.

Main Results:

• Thyroid surgery: 114,500 cases; nearly equal proportions by otolaryngologists (58,098) and general surgeons (56,402).
• Otolaryngologists more frequently performed hemithyroidectomy (43.29%) compared to general surgeons (36.09%).
• Parathyroid surgery: 21,062 cases; general surgeons performed a larger proportion (68.75%) than otolaryngologists (31.25%).
• Significant variation (6- to 9-fold) in trainee case numbers across sites, reflecting training exposure and interest.

Conclusions:

• Thyroid surgical care is equally shared between general surgeons and otolaryngologists.
• Both specialties are significant contributors to parathyroid surgical care.
• Collaborative input and targeting of research, quality improvement, and education interventions are recommended for both specialties.