Do Patients Benefit from Second Opinion Programs?
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The author offers a model of patient decisionmaking and uses it to demonstrate several propositions: (1) second opinion programs redistribute welfare; (2) second opinion programs redistribute financial as well as medical welfare; (3) whatever the standards one might set for surgical necessity, second opinion programs probably eliminate surgeries that meet the standard as well as those that do not; (4) programs are far more likely to reduce reimbursement costs for some types of surgery than for others, and the effects on reimbursement costs are likely to vary among types of programs and among communities; and (5) the effects of second opinion programs depend in part on how a panel of second opinion physicians is selected from the larger population of physicians. Three distinct types of second opinion programs are examined. For each type of program the author identifies the conditions under which reimbursement costs would rise or fall, how welfare is redistributed, and how the selection of a second opinion physicians' panel can affect outcomes.
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