title: Attitudes towards second opinion services in cancer care: a nationwide survey of oncologists in Korea.
abstract: OBJECTIVE
  Second opinion is a common phenomenon in many health systems, especially in the care of patients with cancer. However, it is not clear whether second opinion seeking should be promoted or discouraged and how second opinion services and policies can be better formalized to maximize the benefits and minimize the disadvantages.
  
  
  METHODS
  A nationwide survey was conducted with a representative sample of 678 physicians involved in cancer care (75.5% participation rate) recruited in 13 cancer centres.
  
  
  RESULTS
  Most physicians involved with cancer care perceived patients' second opinion seeking as a legitimate right (96.0%) and they acknowledged the need for second opinion services under certain conditions (98.2%). Many believed that second opinions can enhance patient satisfaction (77.3%) and quality of care (74.3%), but they also had concerns about increase in healthcare and societal costs (91.3%) and concentration in a high-volume centre (90.7%). While the majority agreed with the involvement of the first opinion physicians in the second opinion services (69.5%), there were mixed opinions regarding the desirability of remote (teleconsultation) second opinion services (49.0%) and coverage by national health insurance (51.9%).
  
  
  CONCLUSIONS
  Physicians were generally positive to second opinion services and expected positive consequences in terms of patient satisfaction and quality of care. However, they had concerns about the consequences regarding cost and equity, and disagreements were observed regarding the way to improve second opinion services. The physicians' opinions revealed in our study will be helpful in developing clearer guidelines used to maximize the benefits of second opinion services.
authors.affiliation: Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Department of Health, Behavior and Society & Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA Cancer Education Center, Samsung Comprehensive Cancer Center, SAHIST and School of Medicine, Sunkyungkwan University School of Medicine, Seoul.
authors.forename: Juhee
authors.initials: J
authors.lastname: Cho
authors.affiliation: Division of Cancer Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang.
authors.forename: Hyung Kook
authors.initials: HK
authors.lastname: Yang
authors.affiliation: Division of Cancer Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang.
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Division of Cancer Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang.
authors.forename: Hyung Kyun
authors.initials: HK
authors.lastname: Mok
authors.affiliation: Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyejin
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Chungbuk National University College of Medicine, Cheongju.
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
authors.affiliation: Department of Urology, Jeju National University Hospital, Jeju National University College Medicine, Jeju.
authors.forename: Jung Sik
authors.initials: JS
authors.lastname: Huh
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Head & Neck Oncology Clinic, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang.
authors.forename: Junsun
authors.initials: J
authors.lastname: Ryu
authors.affiliation: Division of Cancer Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea jonghyock@gmail.com whitemiso@ncc.re.kr.
authors.forename: Jong Hyock
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D017060:Patient Satisfaction; D010465:Perception; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D012017:Referral and Consultation; D056910:Republic of Korea; D011795:Surveys and Questionnaires
keywords: Korea; attitudes; cancer; physician; second opinion