Brazilian doctors' perspective on the second opinion strategy before a C-section

Area of Science:

• Obstetrics and Gynecology
• Health Services Research
• Public Health Policy

Background:

• Cesarean section rates are a significant global health concern.
• The implementation of a second opinion strategy aims to moderate surgical intervention rates.
• Understanding physician perspectives is crucial for evaluating healthcare interventions.

Purpose of the Study:

• To assess Brazilian doctors' opinions on the effectiveness and feasibility of a second opinion strategy for Cesarean section decisions.
• To explore reasons behind the perceived effectiveness and feasibility of this strategy in different healthcare settings.

Main Methods:

• A structured questionnaire was administered to 142 physicians across intervention and control hospitals in Brazil.
• Data analysis involved descriptive statistics to evaluate physician opinions on strategy effectiveness, recommendation, and feasibility.
• Physicians' reasons for recommending or not recommending the strategy, and for deeming it feasible or not, were documented.

Main Results:

• Approximately 50-65% of doctors viewed the second opinion strategy as effective or potentially effective.
• A large majority (87-95%) considered the strategy feasible in public hospitals.
• Feasibility in private hospitals was rated lower (64-70%), with doctors citing reluctance to accept colleague interference in decision-making.

Conclusions:

• The second opinion strategy is perceived by physicians as a potentially effective method for reducing Cesarean section rates.
• Physician acceptance and perceived feasibility of the second opinion strategy are significantly lower in private healthcare institutions compared to public ones in Brazil.
• Barriers to implementation in private settings appear linked to professional autonomy and decision-making processes.