A new study by Ben-Gurion University of the Negev (BGU) shows that physicians who give second opinions may be influenced by the first opinion and other external factors.

In what is being called the first study of its kind in the world, Dr. Geva Waschitz, Dr. Nadav Davidovich and Prof. Yosef Pliskin, and other researchers at Soroka University Medical Center in Beersheba, conducted their study to determine whether doctors who give second opinions are influenced by the first opinion.

The researchers presented hypothetical scenarios with no clear cut clinical answers to a national sample of orthopedic surgeons and neurologists. Some were told that the patients had previously received treatment recommendations, but were not told what they were, while others were told the first opinion. One group was informed that after each gave his or her opinion, the patient would be seeking an additional opinion from another doctor.

The results showed that when the orthopedic surgeons knew that the first doctor had recommended a more interventional treatment, the doctor giving the second opinion was more likely to recommend one, too. However, when those same doctors were informed that their patients would seek another opinion, the orthopedic surgeons were more likely to recommend more conservative treatment instead, such as physiotherapy.

“In addition to the quantitative study, personal in-depth interviews with 35 orthopedic surgeons and neurologists found that they generally had a positive view of second opinions, and even encouraged patients to seek them. But second opinions also involve difficulties in patient-doctor relationships, and among specialists themselves. It is difficult for patients to choose what to do when several doctors offer conflicting advice,” said BGU Prof. Joseph Pliskin, the Sidney Liswood Chair in Health Care Management.

In Israel, many patients take advantage of the right to ask for a second medical opinion as this action is subsidized by their health funds’ supplementary health insurances. However, surveys in America show that about half of all Americans never seek a second opinion about a diagnosis, treatment, drug or operation.

Specialists in the BGU study also noted the tension between public and private medicine, urban and periphery accessibility, as well as family and religious leaders’ involvement when seeking a second opinion, and the legal and economic aspects of second opinions.