Francis DO, et al. - THe proposition scrutinized herein was that the rates of thyroid surgery differed across US geographic regions. A 6.2 fold variation was detected in the thyroidectomy rates in the United States, more than prostatectomy rates, which held as the example of the procedure with the widest variation in the United States. Such a difference in the thyroidectomy rates observed among Medicare beneficiaries was indicative of widely divergent local beliefs and practice patterns surrounding the management of thyroid nodules and cancer. This was attributed to the rates being unrelated to the healthcare availability, regional socioeconomic status, or surgeons per capita. The underlying mechanism of this variation warranted additional exploration.