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May 1991

Second Opinion Programs: Time for Another Opinion?

Author Affiliations

Virginia Mason Clinic, Seattle, Wash

Arch Otolaryngol Head Neck Surg. 1991;117(5):474. doi:10.1001/archotol.1991.01870170016001

Second surgical opinion programs evolved in the early 1970s in an attempt to address the variations in practice patterns. With the recognition that the rates of surgery varied appreciably and independently of the health status of the patients studied, plans were devised to weed out the "unnecessary" surgery being performed. As the years have passed, however, the focus on quality assurance has shifted to cost containment, and, with it, the structure and intent of surgical second opinion programs. The increasing presence of managed care and an increasing burden of accountability from patients, payors, and regulators translates into facial plastic surgeons having to more frequently deal with the issues surrounding the structure and effectiveness of second surgical opinion programs.

Analysis of the effectiveness of second opinion programs has revealed some consistent trends. First, the structure of the program, in large part, determines the likelihood of its success. Important factors include whether