Why the world’s best surgeons all work together at the Hospital for Endocrine Surgery

The Hospital for Endocrine Surgery is the world’s top hospital for all types of endocrine surgery, including both open and robotic thyroid and parathyroid surgery for patients with thyroid disease, thyroid cancer as well as parathyroid tumors and primary hyperparathyroidism, respectively. The Hospital is also home to world-renowned adrenal surgeon Dr. Tobias Carling, with patients from all over the globe traveling to have him operate of their adrenal tumors and cancers.

You may be asking yourself, what makes the Hospital for Endocrine Surgery so unique and why should I care?

If you or your loved one is having surgery for a thyroid, parathyroid or adrenal problem, you should care about the quality of the Hospital for Endocrine Surgery and the culture, which makes it unique. The Hospital for Endocrine Surgery is the only one of its kind in the world.

Jim Norman of the world-famous Norman Parathyroid Center (NPC) deserves some credit here. He had a vision that all patients with parathyroid tumors and primary hyperparathyroidism deserve to have at least 2 world-class surgeons operating on them. This created a culture of collaboration.

This may seem like an obvious concept, but to this day, American surgeons largely work in isolation, by themselves, in a silo. This is not good for you. This is how tragedies like Dr. Death could be allowed to happen. 

What makes the culture unique at the Hospital for Endocrine Surgery?

1. The top 0.01% of surgeons are recruited to the Hospital for Endocrine Surgery.
2. The surgeons at the Hospital for Endocrine Surgery always work together and there are at least two world-class surgeons in each operation.
3. The surgeons at the Hospital for Endocrine Surgery do not work in a silo. They are constantly seeking ways to help each other out.
4. The stress-level at the Hospital for Endocrine Surgery is minimal for surgeons, nurses, scrub technologists, and other staff.
5. The Hospital for Endocrine Surgery is laser focused on excellence in clinical care, perfect outcomes for patients and a super pleasant experience.

1) The very best of the best surgeons (Top 0.01%) are recruited to the Hospital for Endocrine Surgery.

Similar to New York Yankees of old, the 80s Chicago Bulls, or our own current Tampa Bay Lightning, the very best of the best surgeons are recruited to the Hospital for Endocrine Surgery. Only the top 0.01% of surgeons are recruited to the Hospital for Endocrine Surgery. If this was the NHL or NFL, our surgeons would all be the top picks in the first round of the draft. We recruit the very best of the best.

Are we bragging? Well, check for yourself! If you wish to scrutinize everyone’s credentials, check out the links below.

Thyroid surgery: https://www.thyroidcancer.com/about-our-surgeons

Adrenal surgery: https://www.adrenal.com/tobias-carling 

Parathyroid surgery: https://www.parathyroid.com/surgeons

Figure 1. Two of the world’s top endocrine surgeons, Dr. Carling, and Dr. Clayman working together removing a neck paraganglioma (similar to a pheochromocytoma) from a patient’s carotid artery. With their combined expertise this operation was performed in about 45 minutes, very safely, whereas at most major Top 10 ranked University Hospitals it would have been a 3-5 hour pretty dicey operation. In fact, the patient was denied surgery at all major University Hospitals in the Mountain West, because the surgeons were inexperienced and afraid.

2) The surgeons at the Hospital for Endocrine Surgery always work together and there are at least two world-class surgeons in each operation

Again, Jim Norman of the Norman Parathyroid Center (NPC) deserves credit here. He had a vision that all patients with parathyroid tumors and primary hyperparathyroidism deserve to have at least 2 world-class surgeons operating on them. This created a culture of collaboration. This may seem like an obvious concept, but to this day, American surgeons, after training largely work in isolation, by themselves, in a silo. This is not good for you. This is very important for patients to understand.

After surgeons have finished their residency, they become board-eligible and then if they pass their surgery board exam, board-certified. Just because someone is board-certified does not make them a master surgeon. Not even close. It is like saying that anyone who has played varsity tennis is as good as Roger Federer. Ridiculous! True Mastery of Surgery is very rare (just like people such as Michael Jordan, Wayne Gretzky, Ingmar Stenmark, Tom Brady, and Roger Federer are exceptional). Fortunately, in endocrine surgery all true surgical masters play on team Hospital for Endocrine Surgery.

Following residency, surgeons can either open a solo practice, join a group practice or a university practice and start operating. At this point they can select which patients they want to operate on. Also, many do so in isolation, by themself. Often, attending surgeons may operate with a first assistant, a scrub technologist, or a resident. However, these assistants are not in a position of authority visavi the attending surgeon. If mistakes happen during the operation, the assistants may not realize it, or may risk losing their livelihood for speaking up. Even in a group or university practice, it is unusual that surgeons scrub in on each other’s cases. Many times, the egos are huge, and many surgeons do not like other surgeons watching them operate. I have never met a master surgeon who does not welcome visitors into their operating room. Conversely, I have met many subpar and worse surgeons who do not wish to have a visitor in the OR.

Figure 2. World’s highest-volume and most talented parathyroid surgeons, Dr. Mitchell and Dr. Ruan working together inspecting all 4 parathyroid glands in a patient with a parathyroid tumor and primary hyperparathyroidism.

Of course, there is some oversight of surgeons through the hospital credentialing committee as well as state medical license boards. But there are stories over and over again, where surgeons in isolation can continue to perform mistake after mistake, and patients get hurt.

Here at the Hospital for Endocrine Surgery, we love having people and our fellow surgeons watch us operated. Why? Because we are great, and we know what we are doing. We just do not mess around. Also, we know that we evolve and learn from each other, and we put aside our egos for the best of the patient. Four eyes can sometime see more than 2 eyes!

Maybe the most publicly known case of the problem of surgery in a silo, in isolation, is the infamous case of the neurosurgeon Dr. Duntsch (also known as Dr. Death), who notoriously mutilated a number of patients and killed some of them. There has been a podcast and TV series about this case.

You want your world class surgeons to work collaboratively. You want an open-door policy into the operating room (with careful infection prevention, of course). You do want honesty and transparency of your surgeon. This is why the two-surgeon operation performed at the hospital of Endocrine surgery is genius. This is very good for you as a patient. Imagine not only having one world-class surgeon doing your operation, but 2 world-class surgeons. What could be better!?

Figure 3. Any patient can rest assured when world’s top parathyroid surgeons Dr. Watkins and Dr. Parrack are working together, and efficiently and safely remove a parathyroid tumor in primary hyperparathyroidism.

3) The surgeons at the Hospital for Endocrine Surgery do not work in a silo. They are constantly seeking ways to help each other out.

Here at the Hospital for Endocrine Surgery, we love having people and our fellow surgeons watch us operate, and we always operate together. Why? Because we evolve and learn from each other, and we put aside our egos for the best of the patient. Four eyes can sometime see more than 2 eyes! We do not work in a silo and in isolation. We work together, collaboratively.

This sometimes may seem confusing to some patients. They are used to being the patient of one surgeon, and only one surgeon. Sometimes they get surprised that they get to meet two or even three world-class surgeons the same day.

Do not be confused, though. There is always one surgeon in charge, similar as there is only one captain on the ship and only one main pilot on the aircraft. But all of you know there is at least one co-pilot on every flight. In fact, on long international flights, there are sometimes 4 pilots. This is a similar model that we use.

We all get along beautifully. We always look for ways to help each other out for the best of the patient. For instance, if one surgeon has a case that is running a little bit longer than usual, we constantly seek ways to help each other out such that the patient does not have to wait and can have their operation perfectly and expeditiously.

Figure 4. Dr. Carling and Dr. Rhodes love operating together and since they have performed more than 1,000 cases in concert, the operation flows like a perfect Vienna orchestra.

4) The stress-level at the Hospital for Endocrine Surgery is minimal for surgeons, nurses, scrub technologists, and other staff.

It is no surprise that a team which works together day in and day out and do the same kind of tasks (in this case, very sophisticated endocrine surgery), work better when they do it day in and day out. If you go to a typical university hospital it is not uncommon that a surgeon has never met the anesthesiologist or the other team members before. This is not good for you. The surgeon may work with different teams and for endocrine surgery, which is relatively rare at most university and community hospitals, it is often “the first time every time”. 

The operating room is by its very nature a stressful place. Many issues are at stake and there is an inherit risk in any surgical operation. However, working with the same team day in and day out and having your very best friends as your co-surgeons make the Hospital for Endocrine Surgery the least stressful surgical hospital in the world.

Figure 5. The supremely accomplished thyroid surgery team with Drs. Clayman, Roy and Walsh were happy to welcome the first patients at the brand-new Hospital for Endocrine Surgery in January 2022.

If you have a difficult operation, you know that right next to you is another 1-6 world experts of the same operation. This is reducing the stress level tremendously for the surgeon, which make him or her perform at the highest level. When the surgeon’s stress level is low, it also makes for a much more pleasant working environment for everyone involved including anesthesia, nurses, surgical technologist and even the janitors. We are all just one family all working for the best possible outcome for the patients in a very pleasant atmosphere.

Contrast this to the typical university or community hospital where the team members do not know each other, trainees are messing things up, and it’s often “the first time every time”. This is why mistakes happen. Here at the Hospital for Endocrine Surgery, we work with the same team every day and we literally have done this thousands of times before. We have seen everything before.

Figure 6. Drs. Carling, Rhodes and Suh celebrate the perfect outcomes of the first scarless robotic thyroidectomy cases ever performed in Florida.

Learn more about scarless robotic thyroid surgery and Dr. Suh here.

5) The Hospital for Endocrine Surgery is laser focused on excellence in clinical care, perfect outcomes for patients and a super pleasant experience

Nobody is practicing on you at the Hospital for Endocrine Surgery. There are no students, trainees or residents operating on you. The Hospital for Endocrine Surgery is laser focused on excellence in clinical care, perfect outcomes for patients and a super pleasant experience. In comparison, big famous university hospital has other major missions such as research and education. Recently, a 4^th focus of university hospitals is on enhancing equity, inclusion, and diversity and many such large hospital systems are “reimagining health”. All these missions are, of course, valuable, but that means that excellence in clinical care takes a back seat at a university hospital. Trust me, you want to have your endocrine surgery operation at a hospital which is supremely focused on excellence in clinical care and perfect patient outcomes. Too many missions of an organization risk making none of them reach the level of excellence. It is very difficult to be the best in the world on endocrine surgery if you are not 100% committed to the best care and outcome for the patients.

Figure 7. All surgeons do clean up pretty well too…

Additional Resources

• Become our patient by filling out the form at this link. 
• Learn more about The Clayman Thyroid Center here. 
• Learn more about our sister surgeons at the Scarless Thyroid Surgery Center, Norman Parathyroid Center, and Carling Adrenal Center
• Learn more about the Hospital for Endocrine Surgery.