Factual survey of second-opinion consultation in Department of Urology

Abstract

To accomplish the appropriate medical care based on informed consent, second-opinion consultation is recommended. Although the patient is requested to bring a referral letter from the original physician and he/she is expected to return to the physician after the second-opinion consultation, this process may not be always obeyed. Therefore, to clarify the current status and problems of the second-opinion consultation in urological diseases, factual survey was performed.

A total of 164 patients who visited the second-opinion clinic at Department of Urology, Tokyo Kosei Nenkin Hospital from November 2004 to March 2011, were included. Characteristics of the patients, methods of consultation and outcomes were investigated and analyzed.

Of 164, 155 were male and 9 were female patients with a mean age of 68.4 years (range：33-94). The present addresses of the patients were Tokyo Prefecture in 90, Chiba Prefecture in 25, and Kanagawa Prefecture in 13, resulting in 143 cases (87%) in Kanto Area. Family member(s) visited without the patient in 8 cases (5%) and the patient visited without a referral letter in 23 cases (14%). The most common diagnosis was prostate cancer (135 cases, 82%), and the majority (155 cases, 95%) was urological malignancy. After consultation, 93 cases (56%) returned to the original physician, 37 cases (23%) decided to receive treatment at our hospital, and the results were unknown in 34 cases (21%). The patients coming from outside Kanto Area, bringing a referral letter, and of prostate cancer, more frequently returned to the original physician.

The majority of the patients who visit the second-opinion consultation had urological malignancy, especially prostate cancer. If the patient was convinced of the treatment option, he/she would certainly return to the original physician.