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Related Concept Videos

Psychosurgery01:30

Psychosurgery

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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
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Spine surgeons facing second opinions: a qualitative study.

Bertrand Debono1, Guillaume Lonjon2, Antoine Guillain3

  • 1Paris-Versailles Spine Center (Centre Francilien du Dos), Paris, France; Ramsay Santé-Hôpital Privé de Versailles, Versailles, France.

The Spine Journal : Official Journal of the North American Spine Society
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Summary
This summary is machine-generated.

Spine surgeons often view patient second opinions negatively, perceiving them as a breach of trust. Shifting this perspective could enhance the physician-patient relationship and shared decision-making.

Keywords:
Decision-makingDoctor-patient relationshipGrounded theoryQualitative studyReferralSecond opinionSpine surgerySurgical consultation

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Medical Sociology

Background:

  • The traditional physician-patient dyad is disrupted by modern social and technological changes.
  • Patient-initiated second opinions can strain mutual trust, a dynamic rarely studied from the surgeon's viewpoint.

Purpose of the Study:

  • To explore spine surgeons' perspectives on patients seeking second opinions.
  • To understand how second opinions impact the surgeon-patient relationship and trust.

Main Methods:

  • Qualitative study using grounded theory and inductive methodology.
  • Semistructured interviews with 24 spine surgeons (orthopedists and neurosurgeons) until data saturation.
  • Thematic analysis triangulated by an anthropologist, psychiatrist, and neurosurgeon.

Main Results:

  • Five themes emerged: patient motivations, impaired trust/disloyalty, surgeon ego/authority, managing second opinions, and avoidance strategies.
  • Surgeons perceive second opinions as a breach of loyalty and trust, impacting their ego.
  • Both surgeons and patients navigate power, control, loyalty, and autonomy within consultations.

Conclusions:

  • Spine surgeons often view second opinions negatively, associating them with disloyalty and ego injury.
  • A paradigm shift is needed to reframe second opinions as a valuable tool for enhancing the physician-patient relationship.
  • Optimizing shared surgical decision-making can be facilitated by a more positive perception of second opinions.