Distance Surgery Program

Program Overview

The Center for Endocrine Surgery in Los Angeles does provide care to patients residing outside of Southern California.  Below, you can see where our distance patients came from over recent years.  They generally fit into 4 categories:

1. Patients residing in under-served or rural areas (i.e. areas with inadequate health care resources) of California, Nevada, and Arizona.
2. Patients residing in other under-served areas of the country, who are obligated to fly to access expert care.  For these patients, there is little difference between a 1-hour flight and a 3-hour flight, so many of them choose to come to Los Angeles.
3. Patients whose family members or other social supports live in Los Angeles.
4. International patients who use UCLA Health as a destination center for their care.

If you are interested in our distance surgery program, please submit an online appointment request. We will try to respond within one business day to arrange the following:

• Transfer of relevant medical records and chart review by one of our surgeons.
• Initial video visit with one of our surgeons

Thereafter, our office will create an itinerary for you, and you will be offered a number of dates to choose from.  The typical itinerary has a duration of 3 days:

• Day 1: Travel to Los Angeles, blood tests and scans if needed, and in-person consultation with ultrasound.
• Day 2: Surgery followed by 4- to 23-hour observation depending on case complexity.
• Day 3: Return travel.

Follow up is performed over video. Many patients choose to spend extra time in Los Angeles before or after surgery to enjoy the beach, shopping, restaurants, and other attractions.  Though our distance program is designed to provide convenience and minimize travel time, please keep in mind that not all conditions can be managed in a single trip to Los Angeles.  Patients who have recurrent cancer and some others with a history of prior neck surgery may require two separate trips: one for evaluation and another for surgery.

Santa Visits Dr. Livhits

Santa Visits Endocrine Center UCLA

Minimally Invasive Parathyroidectomy
By SANTA

I’m writing to commend UCLA Health, the UCLA Endocrine Center & the Ronald Reagan UCLA Medical Center for my recent successful minimally invasive parathyroidectomy. Dr. Masha Livhits and Dr. Lauren Orr reviewed the pre-op material submitted by my General Practitioner in Alaska, personally examined, and successfully operated on me less than a week ago. And, I’m now back in North Pole, Alaska, enjoying an early Spring.

Read more about Santa's story

The map below depicts hometown locations of distance program participants as of March, 2019: 1092 patients, 1062 domestic, from 35 states (and territories) of the US, 30 international from 17 countries.

Eligibility

In order to be eligible, patients must live more than 2 hours’ drive away (without traffic) from UCLA and be in good general health. The program’s strategy involves maximum utilization of suitable medical services in the participant’s local area, followed by a concentrated period of specialty services (imaging, consultations, pre-operative evaluation, and surgery) performed at UCLA spanning one week or less. Effective communication between our office, the patient, and referring physician is essential.

Endocrine Center Distance Surgery Map

Workflow

Our goal is to minimize out-of-pocket medical expenses, travel time, and overall impact on the patient’s schedule.  The typical workflow, which involves creating a preliminary plan at a distance which is then refined after further workup at UCLA, is shown below.

Thorough preparatory work is required to ensure a smooth experience.  After initial contact, our office will provide a brief checklist outlining the records and tests results necessary to establish the diagnosis. All outside biopsy specimens are routinely reviewed by a UCLA endocrine pathologist.

Sample schedule

*If you would like to participate in our distance program, please advise us several weeks in advance of your arrival, preferably when you first contact us. It is essential that we reserve slots for the operating room and medical imaging facilities to make your experience as smooth as possible.

A typical itinerary is shown below. Some patients may require hospitalization beyond 1 night depending on their condition.  You can expect that our staff will create a customized itinerary for you.

Hotels

Many of our patients choose to stay at the UCLA Tiverton House or UCLA Guest House.

• Additional lodging options
• Additional information for patients and visitors

A Word About Traveling for Surgery

Traveling for Surgery

Here is the best advice we can offer to patients who are considering traveling for thyroid, parathyroid, or adrenal surgery: your best option is to find an expert surgeon close to your home. Staying close to home for surgery has the following advantages:

1. Your family and friends can best support you through surgery, recovery, and follow-up care.
2. Reduced travel time, cost, and time away from work.
3. Any complications or problems that arise after surgery can be managed by the operating surgeon.
4. Reduced fossil fuel consumption (seriously!)

These are all very important considerations, but #3 is critical. Each year, we manage complications of surgery that have been created by other surgeons: wound problems, hypoparathyroidism (low calcium), etc. It is a surgeon’s responsibility to manage his/her own complications, as they know exactly what happened during surgery. This is part of the covenant we make with our patients.

If you live outside of Southern California and are seeking endocrine surgical care, please start by visiting the American Association of Endocrine Surgeons (AAES) Find a Surgeon page. This page, originally created by Dr. Yeh in 2012, allows you to input your location and find expert endocrine surgeons near you. AAES surgeons are extensively vetted in order to become members. We suggest browsing a few bios of surgeons near you and scheduling consultations with one or two of them. Most Americans live within driving distance of an AAES member. At least meet with one of them before you consider traveling.

Many U.S. patients who have traveled to UCLA for surgery from outside of Southern California/Nevada area did so because they have close relatives living in Los Angeles. If you live near a major University medical center, it is likely that an endocrine surgery specialist can be found there. Traveling for surgery is sometimes necessary if you have an unusual condition that requires specialized medical care. Most endocrine operations do fall into this category, as high-volume centers are known to have improved patient outcomes compared to non-specialty centers for thyroid, parathyroid, and adrenal surgery.

That said, we strongly feel that patients should have surgery while staying near family and other social supports whenever possible. In other words, stay close to home if you can. Though minimally invasive techniques have shortened recovery time from surgery by a large margin, surgery (even "minor" surgery) remains a physically and emotionally stressful event. Thus, it goes without saying that patients benefit from being near family and friends.

Specialized endocrine surgery centers exist in most major U.S. cities and tend to be clustered around universities. Most people in the U.S. should not have to travel more than a few hundred miles to reach one of these centers. To find an endocrine surgery center near you, please feel free to contact us by phone or email - we will be happy to help you find the resources that you seek.

Follow up

Follow up is performed remotely using our telemedicine program.

Please contact our office if you would like to participate in this program.