Second medical opinions: the views of oncology patients and their physicians.
BACKGROUND
Second medical opinions (SMOs) are common in oncology practice, but the nature of these consultations has received relatively little attention. This study examines the views of patients with advanced cancer and their physicians of SMOs.


METHODS
Parallel, concurrent surveys were developed for patients and physicians. The first was distributed to outpatients with advanced cancer-attending specialist clinics in an Australian quaternary hospital. The second survey, developed on the basis of results of exploratory interviews with medical oncologists, was distributed to medical oncologists in Australia.


RESULTS
Seventeen of fifty two (33%) patients had sought a SMO, most commonly prompted by concerns around communication with their first doctor, the extreme and desperate nature of their medical condition and the need for reassurance. Most (94%) patients found the SMO helpful, with satisfaction related to improved communication and reassurance. Patients were concerned that seeking a second medical opinion may affect their relationship with their primary doctor. Most physicians (82%) reported seeing between one and five SMO per month, with patients being motivated by the need for additional information and reassurance. Physicians regarded SMO patients as having greater information needs (84%), greater psychosocial needs (58%) and requiring more of the physician's time and energy (77%) than other patients.


CONCLUSIONS
SMOs are common in cancer care with most patients motivated by the need for improved communication, additional information and reassurance. Physicians identify patients who seek SMOs as having additional psychosocial needs compared with other oncology patients.
Palliative Care Service, Centre for Palliative Care Education and Research, St. Vincent's Hospital and University of Melbourne, Fitzroy, Melbourne, Victoria 3065, Australia. Jennifer.philip@svhm.org.au
Jennifer
J
Philip
Michelle
M
Gold
Max
M
Schwarz
Paul
P
Komesaroff
D001315:Australia; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D012017:Referral and Consultation