Second Opinion in der Onkologie

The term ‘second opinion’ in Germany refers to the response, by a second and independent physician, to a patient’s request that their existing diagnostic and/or therapeutic situation be reevaluated. There is neither an obligatory definition of this term nor a legal basis or a basis of profession-policy. In the USA the term ‘second opinion’ has been established in a somewhat different form. There, it usually refers to a second opinion commissioned by medical insurance companies, most commonly before surgical. The tendency to request a second opinion seems to be increasing in Germany as well. The main motives for asking a second opinion are insecurity in difficult moments (especially in palliative therapeutic situations), as well as the wish to learn more about alternative forms of treatment. Here we report on practical experiences, characteristics of second opinions in surgery and radiooncology, reimbursements, and certain conflicts a second opinion may cause.