At a Glance
- Philip Smith, MD, FACS, Assistant Professor of Surgery at UVA
- Specialty: Endocrine Surgery
- Fellowship: Endocrine Surgery, Columbia University Medical Center
- Residency: Surgery, UVA Health System
- Medical Degree: University of Virginia
Surgeon Philip Smith is no stranger to UVA. He completed his undergraduate, graduate and post-graduate degrees in Charlottesville. “It is a positive educational environment. That is a huge part of why I stayed at UVA,” he says. Smith had the opportunity to work alongside surgeons who set the bar high for both surgical expertise and teaching. “I had incredible role models at UVA, including John Hanks and Bruce Schirmer. They modeled the clinical professionalism that I admired; I knew I wanted to continue working with them,” Smith explains.
With the retirement of John Hanks earlier this year, Smith is now managing all patients requiring endocrine surgery, in collaboration with a team of endocrine specialists. “UVA has a well-established endocrine program, so it’s a great place to collaborate and provide multidisciplinary care,” he says.
Learn more about Smith and his role at UVA in the Q&A below.
What is your clinical focus?
I treat benign and malignant diseases of the thyroid, parathyroid and adrenal gland, including problems of function, as well as problems of mass effect resulting from a nodule or goiter. Fortunately, most of the conditions I care for have a positive prognosis. My goal is to be thoughtful in selecting appropriate surgical interventions — to not over or under treat — with as low morbidity as possible and as efficiently as possible.
How is UVA unique in its management of these conditions?
One example is that we have started using a different approach to adrenalectomy. We have been doing this operation laparoscopically for many years, but now we also are using a laparoscopic retroperitoneal approach. For the appropriately selected patient, this approach has fewer risks for complication and a faster recovery even than standard laparoscopic adrenalectomy, so patients can leave the hospital and return to their lives more quickly.
Another example is parathyroid disease. We looked at our prior experience and recognized that when using CT scans, we had an opportunity to decrease radiation exposure. We modified our protocol and have cut the radiation dose in half compared to protocols used at most centers.
Are you also interested in research?
Yes, mostly pertaining to the evaluation of patients with endocrine disorders. We have ongoing work evaluating the most effective and efficient approaches to imaging for parathyroid disease. Another example is that we are questioning some assumptions regarding the best approach to some incidentally discovered radiographic findings of endocrine organs, particularly PET-avid thyroid lesions.
I’m also interested in the use of multiple modalities of simulation in training medical students and surgery residents.
How do you interact with referring providers?
I work closely with endocrinologists, family practitioners, internal medicine providers, referring surgeons and other providers. They may call on me to get my thoughts and opinions on a particular patient and I’m happy to provide as much insight as I can even if I don’t see the patient. My goal is to maintain open communication utilizing whatever modality suits the physician best, whether that is email, phone or Epic.
For patients with thyroid cancer in particular, as the management guidelines have changed, there has to be an open line of communication between me and the referring physician. The surgical treatment I provide changes the way that patient will be managed and followed — if I do a thyroid lobectomy, the patient will have different treatment options than if I do a total thyroidectomy. It’s necessary for us to make a joint decision because they will be caring for the patient long-term.
Learn more about Philip Smith, MD, by scheduling an in-person visit from Smith and a Physician Relations team member. Contact Liz Nottingham at 434.243.2733 or LNottingham@virginia.edu for more information.