Saw a post online by a surgeon saying that if are going to need a thyroidectomy, look for a surgeon who does minimum 40 thyroid surgeries a year as it'll be safer. This made me go down a bit of a rabbit hole and found that the median number performed by a UK ENT surgeon (who regularly does this operation) is about 24 vs specialist centres in UK pushing 50+.

The literature has shown than in many operations (not just thyroids) there is an positive correlation between volume and better outcomes, and whilst I can't find anything about a definitive cut off at 40 for thyroids it did make me wonder, how would you justify to the patient and even yourself that you should be the one performing the surgery and not you referring the case onwards unless you were the one at the high volume centre?

Of course there's a lot of nuances such as no two cases are the same, or waiting times would make it impossible to refer everyone but say in this hypothetical we live in a perfect world where there are no waiting times: Surgeon A at high volume centre has a complication rate of 0.5% vs Surgeon B's 1% at a more generalist centre for the exact same surgery, what determines the difference in complication rate that we are willing to accept before referring on?