In an effort to comply with Governor Whitmer’s coronavirus ‘Stay at Home’ order, Advanced Thoracic now has updated hours and services. We continue to follow CDC Guidelines for patient appointments, including limiting the number of people with patients and social distancing. For questions concerning appointments or other medical questions, hours of operations and phone numbers are listed below:

Monday – Thursday, 8AM-4:30PM
Friday, 8AM-12PM
Phone: (517) 999-4370

What is Thoracic Surgery?

What is a thoracic surgeon?

A thoracic surgeon is a surgeon that performs surgery on the organs, tissues, and structures of the chest including the lungs, esophagus, chest wall, diaphragm, mediastinum, and heart.  It can get confusing, but thoracic surgeons may be called or referred to in many ways including cardiothoracic surgeons, cardiovascular surgeons, thoracic surgical oncologists, general thoracic surgeons, and congenital heart surgeons.

Are all thoracic surgeons the same?

No.  While all board-certified thoracic surgeons have the same general training and are certified by the same primary specialty board (American Board of Thoracic Surgery, ABTS), there is wide variation in each practice and provider.  Some surgeons will choose to focus their practice on specific areas and should be referred to differently.  A cardiac or cardiovascular surgeon predominantly focuses on surgery of the heart and great vessels.  A general thoracic surgeon or thoracic surgical oncologist treats and operates on diseases of the lungs, chest wall, esophagus, diaphragm, and mediastinum.  Congenital heart surgeons typically only treat infants and children with heart disease. 

What training is required for a thoracic surgeon?

Thoracic surgeons must graduate from an accredited medical school and will then complete an accredited general surgery residency lasting five to six years.  After that they must successfully graduate through an approved cardiothoracic surgical residency training program of two to three years.  Only after can they qualify to initiate the board certification process.  Some thoracic surgeons may also pursue additional or advanced training in a specialized are of practice which is referred to as a Fellowship. 

What does it mean to be a board-certified Thoracic Surgeon? Fellowship Trained?

The American Board of Thoracic Surgery (ABTS) maintains strict standards for the practice of thoracic surgery in the public interest.  Thoracic surgeons who have completed approved residency training, hold a full and unrestricted license to practice medicine in the United States, and maintain an ethical standing in the profession are eligible for board certification. Candidates must then pass a written examination that is designed to test a broad range of knowledge in all areas of thoracic surgery. Upon successful completion of the written or qualifying examination, candidates are eligible for and must pass an oral or certifying examination that tests knowledge, judgment, and the integration of these skills in clinical practice. Once successful in these pursuits, a thoracic surgeon is “board certified”. To keep this certification, the maintenance of certification process is required to demonstrate lifelong learning throughout the thoracic surgeons’ career.  Fellowship training is additional training that a surgeon may choose to undertake.  These are specialized programs where very advanced skills and experiences are gained by the surgeon.

Adapted from the American Board of Thoracic Surgeons www.abts.org and Society of Thoracic Surgeons www.sts.org

Choosing a thoracic surgeon

Dealing with a thoracic disease can be very stressful and choosing a surgeon for your care is extremely important.  When choosing a thoracic surgeon, the best outcomes come from surgeons whose practice and clinical focus is specifically general thoracic surgery and thoracic surgical oncology.  These are surgeons who, while board certified in all aspects of thoracic surgery, only focus on lung, esophagus, reflux, chest wall, mediastinum, and diaphragm surgery.  They do not do heart or vascular surgery. Having advanced training, experience, and a practice focused in complex chest procedures (non-cardiac) is a major advantage for patients undergoing surgery.  A general thoracic/thoracic oncology focused surgeon works in multi-disciplinary teams with Radiation and Medical Oncologists, Pathologists, and Nurse Navigators to collaborate on decisions for treatments.  Dedicated general thoracic surgeons are up to date on the most advanced practices, procedures, and surgical approaches. Only if your surgeon is a dedicated general thoracic/thoracic surgical oncologist will the outcomes be the best and after all is said and done, a great outcome from surgery is all that really matters so it is critical to try and take every advantage possible.  If a surgeon’s practice is mixed or is predominantly heart or vascular surgery, you should find another surgeon.  If a surgeon does not regularly perform general thoracic cases, you should find another surgeon.  If a surgeon does not regularly perform minimally invasive surgery or if their conversion rate (how often the surgery has to change from minimally invasive to a large open procedure) is high, you should find another surgeon.  If a surgeon is not active in multi-disciplinary treatment teams, you should find another surgeon.

What to ask your surgeon

Any surgeon you want to operate on you or your loved one should be very comfortable discussing this.

If the answer is not a resounding YES, or if a surgeon has to schedule around heart/vascular cases, you should consider if you are getting every advantage.

This is probably the most telling question you can ask, and any surgeon should not be surprised if asked this since they should have this in the forefront of their mind with every patient.

A responsible surgeon should not only discuss if and why a second opinion could be helpful but also is comfortable making a recommendation on who the second opinion would be. This conversation should be able to occur without the surgeon becoming defensive or negative.