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Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: A qualitative study

Title: Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: A qualitative study
Authors: Greenfield, G
Pliskin, JS
Wientroub, S
Davidovitch, N
Item Type: Journal Article
Abstract: Background Second opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians’ attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system. Methods We interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach. Results As a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1) inequalities between central and peripheral regions of Israel; (2) inequalities between private and public settings; (3) implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4) tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions. Conclusions While all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient’s Rights Law. Further studies are needed to assess the patients' perspectives.
Issue Date: 24-Jul-2012
Date of Acceptance: 18-Jun-2012
URI: http://hdl.handle.net/10044/1/69766
DOI: https://dx.doi.org/10.1186/2045-4015-1-30
ISSN: 2045-4015
Publisher: BioMed Central
Journal / Book Title: Israel Journal of Health Policy Research
Volume: 1
Copyright Statement: © 2012 Greenfield et al.; licensee BioMed Central Ltd. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Policy & Services
Public, Environmental & Occupational Health
Health Care Sciences & Services
Second opinion
Health policy
Public medicine
Private medicine
Inequalities
Qualitative research
ALTERNATIVE MEDICINE
CANCER-PATIENTS
ELECTIVE SURGERY
BREAST-CANCER
PROGRAM
EXPECTATIONS
2ND-OPINION
NEURORADIOLOGY
HOSPITALS
SERVICE
Publication Status: Published
Article Number: 30
Online Publication Date: 2012-07-24
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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