title: [Helping the patient to decide].
abstract: Since 1998, a second opinion practice in Amsterdam has tried to find a method for providing the patient with decision support. Current literature is studied and discussed with the patient and support is given with the interpretation of medical information. This also means providing insight into the peculiarities of doctors' diagnostic and therapeutic reasoning. Informed consent or the decision to refuse treatment should be based on sound arguments and balanced information. Due to a disc hernia, a 60-year-old man suffered from immobilizing pain and a loss of strength in his right leg. Surgery was proposed but the patient had found additional information on the Internet, which the neurosurgeon was not prepared to discuss. A 40-year-old woman suffering from incontinence was offered periurethral collagen injection therapy. She had found a medical article on this subject for which she sought an explanation. On the basis of this discussion questions were formulated which she could pose to her urologist. A 70-year-old woman with shoulder pain, who was not satisfied with the pain medication prescribed by her general practitioner, came to discuss the possibilities of second opinion and referral to a specialist. A 29-year-old woman had consented to a surgical correction of a urethral stenosis, now wondered whether she could be treated laparoscopically. She phoned for advice and to find out what sort of questions she should pose to her urologist.
authors.forename: H C
authors.initials: HC
authors.lastname: Coumou
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019635:Neurosurgical Procedures / Q000592:standards; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000639:trends*