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When, in 1974, Dr Eugene McCarthy's first article appeared, something new had been added to the field of medical sociology. The Surgical Second Opinion Program (SSOP) was innovative. It quantified by direct enumeration those occasions when a second physician disagreed with the opinion of a first physician who had advised a surgical operation. Whatever its later interpretations or misinterpretations, the SSOP supplied a new and measurable entity that bore on the use of medical care services.
Because of its interest and implication for surgery, the American surgical establishment was anxious to cooperate. Surgical panels and second opinion groups were set up in several cities and county regions across the country. Discussions of the SSOP became a regular feature of surgical programs in local and national societies. The state chapters of the American College of Surgeons played an active role in selection of consultants. One of the committees of the American