When Alexander Shifrin, MD, reflects on his 20 years as an endocrine surgeon, what stands out most is not the technical complexity of the operations he performs, but the consistency with which he can offer something rare when it comes to cancer care.
“Endocrine surgery is one of the few surgical specialties where patients truly can be cured,” he says. “For thyroid cancers and many parathyroid and adrenal disorders, surgical outcomes are extremely successful. That is incredibly rewarding for both patients and the physicians who refer them.”
As Surgical Director of Endocrine Surgery at Atlantic Health, Dr. Shifrin has spent the last several years building a high-volume, evidence-driven program grounded in clinical rigor, multidisciplinary collaboration, a personalized patient experience, and a strong commitment to timely communication with referring clinicians. The program’s rapid growth at Atlantic Health CentraState Medical Center reflects both rising regional need and the demand for endocrine specialists who combine technical mastery with a thoughtful, patient-centered approach.
A Personalized Approach, Grounded in Strong Evidence
Dr. Shifrin’s philosophy of care is shaped by two principles: unwavering adherence to clinical guidelines and tailored decision-making for each individual patient.
“We follow evidence-based standards of care and current guidelines,” he explains. “At the same time, every patient is unique. A personalized approach is essential.”
Primary care physicians, endocrinologists, nephrologists, and oncologists refer a wide range of cases to the program, such as incidental thyroid nodules, hypercalcemia discovered on routine labs, adrenal abnormalities, or suspected malignancies. What referring physicians consistently experience is a structured, clear diagnostic pathway that removes ambiguity and accelerates appropriate treatment.
Thyroid Nodules: A Common Finding, A Clear Workflow
With thyroid nodules now identified in nearly half of women over age 50, primary care physicians play a central role in recognizing which patients require specialty evaluation. According to Dr. Shifrin, the first steps are straightforward:
- Thyroid function testing
- High-quality thyroid ultrasound, the cornerstone of early risk stratification
Because ultrasound interpretation can vary significantly across institutions and radiologists, patients with indeterminate or suspicious features are often referred to Dr. Shifrin’s team for further evaluation. Fine-needle aspiration (FNA) biopsy, which is performed in-office with on-site cytology assessment, remains the definitive diagnostic tool.
“The only way to determine whether a thyroid nodule is cancerous is through biopsy,” he noted. “Bloodwork cannot replace it.”
The practice also uses molecular classifiers for Bethesda III and IV nodules, helping avoid unnecessary surgeries while confidently identifying high-risk lesions that warrant intervention.
Primary Hyperparathyroidism: Early Recognition Prevents Morbidity
Hypercalcemia is another frequently under-recognized condition in primary care settings.
“Calcium is not always at the top of a clinician’s mind, but even mild elevations can have serious consequences,” Dr. Shifrin says.
Primary hyperparathyroidism can lead to:
- Osteoporosis
- Kidney stones
- Declining renal function
- Neurocognitive symptoms
- Cardiovascular effects
Once biochemical diagnosis is confirmed, typically through elevated serum calcium and parathyroid hormone, patients should be evaluated for surgical candidacy based on the Fifth International Workshop criteria. These include:
- Age <50
- T-score < or = –2.5 at lumbar spine, hip, or wrist
- 24-hour urine calcium >250 mg (women) or >300 mg (men)
- History or imaging evidence of kidney stones
- eGFR <60
- Serum calcium > or = 1 mg/dL above upper limit of normal
One-third of the patients seen in Dr. Shifrin’s office on any given day meet these criteria.
“Parathyroid surgery is highly curative,” he emphasizes. “But just as important is identifying which patients do not require immediate surgery and can be safely managed medically. That’s where personalized evaluation really matters.”
A Commitment to Referring Physicians: Communication Without Delay
For many primary care physicians and endocrinologists, the decision to refer rests heavily on the quality of communication from the receiving specialist. Dr. Shifrin considers this one of the most important aspects of his practice.
“When we receive a referral, we communicate after every serious diagnosis and every visit,” he said. “If a biopsy reveals malignancy, I call the referring physician personally. It ensures coordinated care—and it helps educate clinicians about which nodules or lab abnormalities carry more significance than they may appear.”
Studies consistently show that delayed or incomplete feedback is one of the top reasons physicians stop referring to a specialist. By maintaining a closed loop, the endocrine surgery program reinforces trust and ensures continuity of care.
Precision Surgery and Advanced Outcomes—With an Emphasis on the Human Experience
Clinical excellence remains a defining strength of Dr. Shifrin’s practice. Short operative times, minimal anesthesia exposure, cosmetic incisions, and low complication rates reflect two decades of highly focused surgical expertise.
But the most memorable moments, he says, come from seeing patients reclaim their lives.
He recalls a recent case of a 28-year-old woman with aggressive thyroid cancer and extensive bilateral neck metastases.
“The surgery took eight hours, and I was extremely concerned about the outcome,” he remembers. “To my surprise, the result was extremely successful. I was able to remove all the tumor. When she came back after surgery, she was smiling. She was happy. It was incredibly rewarding.”
Cases like this remind him why endocrine surgery remains a vocation defined not only by technical skill but by its impact.
“Seeing a patient leave the office with a smile is what keeps us going,” he says. “Surgery for cure is an extraordinary privilege.”
A Growing Regional Resource for Endocrine Disorders
Atlantic Health’s Endocrine Surgery Program has quickly become a preferred destination in the region for the evaluation and treatment of thyroid, parathyroid, and adrenal disorders. Its rapid growth reflects a system-wide commitment to building specialty expertise close to home—without compromising the academic-level rigor physicians expect.
“We’ve built a program that treats patients with precision and compassion,” Dr. Shifrin describes. “Our mission is simple: to offer cure when possible, clarity when needed, and thoughtful guidance every step of the way.”
To learn more about the endocrine surgery program or to refer a patient, call 732-792-5003.