The introduction of fine needle aspiration biopsy revolutionised the investigation of thyroid nodules. Several decades on, diagnosis relies largely on the same technique. Meanwhile clinicians are faced with an epidemic of incidentally discovered thyroid nodules and an increasingly informed public frequently misled by unreliable sources. Molecular diagnostics and new imaging techniques are in the horizon, but unlikely to influence clinical practice in the next few years. The time between discovery of a nodule and surgical referral is usually marked by anxiety and uncertainty. How clinicians handle patients during this phase impacts on the rest of their journey. More focus on managing the person rather than investigating the nodule is essential for improving the experience of thyroid cancer patients.