Total thyroidectomy is a logical treatment for many patients with thyroid disease, including patients in whom the pathologic process requiring surgery involves both lobes of the thyroid or the risk of recurrence is a significant consideration, as in benign multinodular goiter, Graves' disease, and cancer. In earlier times the risks of extensive surgery and problems of adequate hormone replacement deterred surgeons from performing total thyroidectomy. However, as we enter the twenty-first century we are confident that the technical aspects of safe total thyroidectomy are established and that thyroid hormone replacement and monitoring are readily available and accurate. In the future total thyroidectomy is likely to be performed increasingly commonly for both benign and malignant disease.

In this paper we use establishment‐level data to examine what managers mean when they report having skills shortages. We find that the concept of a skills shortage is not always the same as a hard‐to‐fill vacancy despite the latter being used by many authors who have considered the economic consequences of skills shortages. It seems that, while employers appear not to have any problems for themselves in interpreting questions on ‘skills shortages’, we cannot rely on them being perceived in a uniform way by all employers. Indeed, many employers stress that, amongst both their existing workforce and job applicants, there appear to be important shortfalls in motivational and attitudinal skills, leading us to believe that social skills are an important part of the skills said to be in shortage. Our findings point to two main conclusions for future research. First, studies that investigate the causes and effects of ‘skill shortages’ need to pay greater attention to their definition and measurement. Secondly, in future research on establishments and their skill formation practices, further steps could be taken to gain clarification either directly or indirectly from respondents as to the experiences they choose to classify as a skills shortage.

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