Does the second opinion directive in Germany reach the patient? A parallel-convergent mixed-methods study

Area of Science:

• Health Services Research
• Patient Decision Making
• Medical Policy Implementation

Background:

• Germany introduced a Second Opinion Directive (SOD) in December 2018 for specific elective surgeries.
• The directive aims to prevent unnecessary surgeries and empower patients in their healthcare choices.
• Physicians are mandated to inform patients about the SOD when relevant procedures are indicated.

Purpose of the Study:

• To investigate the implementation status of the SOD in German clinical practice.
• To understand how physicians inform patients about the SOD.
• To explore patient reactions to being informed about their right to a second opinion.

Main Methods:

• A parallel-convergent mixed-methods study was conducted.
• Qualitative data were gathered through 26 patient interviews.
• Quantitative data were collected via a survey of 102 patients.

Main Results:

• The SOD is not effectively implemented for the studied indications, as patients were not adequately informed.
• Patient interviews revealed a lack of awareness regarding the SOD.
• Explaining the right to a second opinion positively influenced the patient-physician relationship.

Conclusions:

• A significant information gap exists for both physicians and patients regarding the SOD.
• Physician education on the SOD and its importance may improve implementation.
• Enhancing public awareness of the second opinion option is crucial for patient empowerment.