Endocrine Surgeon Says Fellowship Training Gave Her Well-Rounded Understanding of Complex Conditions
Nov 04, 2019 09:53AM
By MED Magazine
Emily Murphy’s roots run deep in medicine in South Dakota. She was still in utero when her mother, now a Sioux Falls pathologist, graduated from medical school. Murphy herself earned her medical degree from the University of South Dakota Sanford School of Medicine and knew early on that she wanted to practice surgery in her home state. She decided that the best way to improve her odds of finding a local position was to develop unique expertise.
“I wanted to have a niche that no one else did so that I would be able to do surgery in the place where I really wanted to do it.” says Dr. Murphy.
Murphy completed her general surgery residency at Christiana Care Health System in Newark, Delaware and went on to complete a fellowship in endocrine surgery at the Medical College of Wisconsin in Milwaukee. She accepted a position at the Surgical Institute of South Dakota and is now the state’s only fellowship-trained endocrine surgeon.
“It is not a new thing to be doing endocrine surgery,” says Murphy. “But a lot of people with fellowship training go to big academic centers and metropolitan areas.”
Dr. Murphy says Surgical Institute of South Dakota was a perfect fit for her. Not only did it offer the chance to practice in her home area, but it allowed her to perform the specialized surgeries she enjoys while keeping her hand in the world of general surgery.
“I did not want to give up doing gallbladder or hernia surgeries, but I also wanted the opportunity to bring this expertise to this area,” says Dr. Murphy.
Murphy’s presence is especially welcome among women, who make up the bulk of endocrine surgery patients. Many of them present with thyroid disorders, of which hyperthyroidism (overactive thyroid) is the most common. An overactive thyroid can cause nervousness, anxiety, sleep problems and heart palpitations. Thyroidectomy is often safer than long-term medication use.
Removal of thyroid nodules (thyroid lobectomy) is another common procedure for Dr. Murphy. As many as half of all women develop a thyroid nodule by age 50. They are typically found by a patient’s primary care physician and confirmed by ultrasound. The results will determine if a biopsy is needed.
“Most of these never cause a problem but occasionally a nodule may be cancerous,” says Dr. Murphy. “In other cases, a nodule may be so sizeable that it becomes hard to swallow or causes shortness of breath.”
Problems with one or more of the four parathyroid glands are often identified incidentally when a primary care doctor orders an electrolyte panel for another reason. When these glands are not working correctly, it can cause leaching of calcium from the bones and worsen osteoporosis or osteopenia. Parathyroid surgery can restore calcium levels to normal and reduce the risk of fragility fractures, especially in post-menopausal women.
Tumors in the adrenal glands, while rare, may lead to dysregulation of key hormones, triggering a cascade of symptoms. About 10 adrenal gland surgeries take place at Surgical Institute of South Dakota annually, making it a high-volume center by national standards. When Murphy performed her first adrenal surgery, her own mother read the report.
“A lot of times people come into my office but they don’t really understand what the issue is,” says Dr. Murphy. “My fellowship allowed me to spend a full year doing all things endocrine. I got to spend time with medical endocrinologists, ENT docs, radiologists and pathologists, which gave me insight into endocrinology in general. It allowed me to be curious and it allowed me to work on helping patients to really understand their condition and their options.”