Purpose: Discrepancies in diagnosis, treatment or prognosis may emerge among physicians. A known decision-making bias is the tendency to shift personal opinion either towards or away from a previous opinion. We sought to evaluate such biases in the context of second-opinion medical consultations.
Methods: We distributed questionnaires to a nationwide sample of orthopedic surgeons and neurologists. The questionnaires presented eight scenarios, each with conventional treatment options with no clear-cut preference. In four scenarios the physicians were told that a previous opinion had already been given by another physician, or that a second-opinion will be given, and the other four scenarios were used as controls. The physicians' responses were coded according to the level of intervention (conservative to interventional).
Results: 172 orthopedic surgeons and 160 neurologists filled out the questionnaires, which represent about 50% of these specialties in Israel. In the orthopedic questionnaire, when a first opinion had already been given, there was a shift towards a more interventionist treatment (p<0.05). This was especially prominent when the first opinion was known to the second physician. When the patient intended to seek a second-opinion, there was a shift towards a more conservative treatment. No such effect was found among neurologists.
Conclusions: A physician’s judgment may be affected by another physician’s opinion (compared to their choices without a first opinion). This bias mainly tends towards a more interventionist treatment. Due to the immense impact of any decision on patient health and resource use, further research should address such biases and develop tools to address them.
Candidate for the Lee B. Lusted Student Prize Competition
See more of: The 32nd Annual Meeting of the Society for Medical Decision Making