Background: Seeking a second-opinion (SO) is a common clinical practice that can optimize treatment and reduce
unnecessary procedures and risks. We aim to characterize the composition of the population of SO seekers, their reasons
for seeking a SO and choosing a specific physician, and their perceived outcomes following the SO.
Methods: A cross-sectional national telephone survey, using a representative sample of the general Israeli population
(n = 848, response rate = 62%). SO utilization was defined as seeking an additional clinical opinion from a specialist within
the same specialty, for the same medical concern. We describe the characteristics of respondents who obtained SOs, their
reasons for doing so and their perceived outcomes: (1) Satisfaction with the SO; (2) Experiencing health improvement
after receiving a SO; (3) A difference in the diagnosis or treatment suggested in the first opinions and the second
opinions; (4) Preference of the SO over the first one.
Results: Most of the respondents who sought a SO (n = 344) were above 60 years old, secular, living with a partner,
perceived their income to be above average and their health status to be not so good. For the patients who utilized
SOs, orthopedic surgeons were sought out more than any other medical professional.Reasons for seeking a SO included
doubts about diagnosis or treatment (38%), search for a sub-specialty expert (19%) and dissatisfaction with
communication (19%). SO seekers most frequently chose a specific specialist based on a recommendation from a
friend or a relative (33%). About half of the SO seekers also searched for information on the internet. Most of the
respondents who sought a SO mentioned that they were satisfied with it (84%), felt health improvement (77%),
mentioned that there was a difference between the diagnosis or treatment between the first opinion and the SO
(56%) and preferred the SO over the first one (91%).
Conclusions: Clinical uncertainty or dissatisfaction with patient-physician communication were the main
reasons for seeking a SO. Policy makers should be aware that many patients choose a physician for a SO based on
recommendations made outside the medical system. We recommend creating mechanisms that help patients in the
complicated process of seeking a SO, suggest specialists who are suitable for the specific medical problem of the
patient, and provide tools to reconcile discrepant opinions.