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. 2012 Jul 24;1(1):30.
doi: 10.1186/2045-4015-1-30.

Orthopedic surgeons' and neurologists' attitudes towards second opinions in the Israeli healthcare system: a qualitative study

Geva Greenfield  1 , Joseph S Pliskin, Shlomo Wientroub, Nadav Davidovitch
Affiliations

Orthopedic surgeons' and neurologists' attitudes towards second opinions in the Israeli healthcare system: a qualitative study

Geva Greenfield et al. Isr J Health Policy Res. .

Abstract

Background: Second opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians' attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system.

Methods: We interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach.

Results: As a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1) inequalities between central and peripheral regions of Israel; (2) inequalities between private and public settings; (3) implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4) tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions.

Conclusions: While all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient's Rights Law. Further studies are needed to assess the patients' perspectives.

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References

    1. Gertman PM, Stackpole DA, Levenson DK, Manuel BM, Brennan RJ, Janko GM. Second opinions for elective surgery. The mandatory Medicaid program in Massachusetts. N Engl J Med. 1980;302:1169–1174. doi: 10.1056/NEJM198005223022103. - DOI - PubMed
    1. Rosenberg SN, Allen DR, Handte JS, Jackson TC, Leto L, Rodstein BM, Stratton SD, Westfall G, Yasser R. Effect of utilization review in a fee-for-service health insurance plan. N Engl J Med. 1995;333:1326–1330. doi: 10.1056/NEJM199511163332006. - DOI - PubMed
    1. Myers SA, Gleicher N. A successful program to lower cesarean-section rates. N Engl J Med. 1988;319:1511–1516. doi: 10.1056/NEJM198812083192304. - DOI - PubMed
    1. Althabe F, Belizan JM, Villar J, Alexander S, Bergel E, Ramos S, Romero M, Donner A, Lindmark G, Langer A, Farnot U, Cecatti JG, Carroli G, Kestler E, Group LACSS. Mandatory second opinion to reduce rates of unnecessary caesarean sections in Latin America: a cluster randomised controlled trial. Lancet. 2004;363:1934–1940. doi: 10.1016/S0140-6736(04)16406-4. - DOI - PubMed
    1. Kronz JD, Westra WH. The role of second opinion pathology in the management of lesions of the head and neck. Curr Opin Otolaryngol Head Neck Surg. 2005;13:81–84. doi: 10.1097/01.moo.0000156162.20789.66. - DOI - PubMed