Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 21;19(1):112.
doi: 10.1186/s12904-020-00619-9.

Second opinions in medical oncology

Ian Olver  1 , Mariko Carey  2   3   4 , Jamie Bryant  2   3   4 , Allison Boyes  2   3   4 , Tiffany Evans  4 , Rob Sanson-Fisher  2   3   4
Affiliations

Second opinions in medical oncology

Ian Olver et al. BMC Palliat Care. .

Abstract

Background: The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why.

Methods: The study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania. Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks.

Results: Of 823 patients screened for eligibility, 698 eligible patients, 612 provided consent. Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%). Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion.

Conclusions: Our study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor. Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate.

Keywords: Cancer; Consultation; Patient-centred care; Quality of care; Referrals; Second opinions.

PubMed Disclaimer

Conflict of interest statement

Author Ian Olver; author Mariko Carey; author Jamie Bryant; author Allison Boyes; author Tiffany Evans and author Rob Sanson-Fisher declare that they have no conflict of interest.

References

    1. Hillen MA, Medendorp NM, Daams JG, Smets EM. Patient-driven second opinions in oncology: a systematic review. Oncologist. 2017;22(10):1197–1211. doi: 10.1634/theoncologist.2016-0429. - DOI - PMC - PubMed
    1. Baker A. Crossing the quality chasm: a new health system for the 21st century. London: British Medical Journal Publishing Group; 2001. p. 1192.
    1. Payne VL, Singh H, Meyer AN, Levy L, Harrison D, Graber ML. Patient-initiated second opinions: systematic review of characteristics and impact on diagnosis, treatment, and satisfaction. In: Mayo Clinic Proceedings. Amsterdam: Elsevier; 2014. - PubMed
    1. Ouwens M, Hermens R, Hulscher M, Vonk-Okhuijsen S, Tjan-Heijnen V, Termeer R, et al. Development of indicators for patient-centred cancer care. Support Care Cancer. 2010;18(1):121. doi: 10.1007/s00520-009-0638-y. - DOI - PMC - PubMed
    1. Tattersall MH, Dear RF, Jansen J, Shepherd HL, Devine RJ, Horvath LG, et al. Second opinions in oncology: the experiences of patients attending the Sydney Cancer Centre. Med J Aust. 2009;191(4):209–212. doi: 10.5694/j.1326-5377.2009.tb02754.x. - DOI - PubMed