title: The scope and impact of thyroid disease.
abstract: Aspects of the incidence and demographics of common thyroid disorders in the US (and elsewhere, to a lesser extent) are reviewed. The impact of healthcare reform and the efforts of managed care organizations to impose cost-effective management for the diagnosis and treatment of thyroid disorders are bringing unusual pressures to bear on both clinical laboratories and practicing endocrinologists. I discuss the potential dangers of utilization of suboptimally focused diagnostic approaches and of the inefficiencies in clinical management by primary-care providers, who often lack sufficient expertise, as opposed to endocrinologists. More than dollars are at stake, and the suboptimal management of common thyroid disorders presents several significant risks. Finally, I propose a general blueprint for the ongoing development of a structure for continuing quality improvement of the laboratory and clinical diagnosis, treatment, and long-term follow-up of patients with thyroid disease.
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA. lxw5@mhg.edu
authors.forename: L
authors.initials: L
authors.lastname: Wartofsky
mesh_terms: D003362:Cost-Benefit Analysis; D003710:Demography; D003955:Diagnostic Tests, Routine; D004704:Endocrinology; D005194:Family Practice; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data; D013959:Thyroid Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D000078329:Workforce