In the literature on thoracic surgery, return to work has received little attention in QOL investigations. At present, it is difficult to appreciate clinically meaningful trends in return to work after thoracic surgery, even within a specialized area, such as lung cancer resection. It is evident, however, that return to work is not a simple variable, easily measured; rather, it is a complex construct that is influenced by a multitude of personal and societal factors. Focusing only on disease-related or treatment-related symptoms renders QOL studies limited in scope and perhaps in usefulness. Return to work is not a trivial component of global postsurgical QOL; it should be recognized as a major factor. Patients have indicated that maintaining return-to-work ability is as highly valued as their overall health. Surgical societies should design, validate, and implement a simple data collection instrument to characterize better return to work after thoracic surgery.