Second consultant opinion for elective gynecologic surgery.

Medical records of 516 patients not confirmed for previously recommended elective gynecologic surgery were abstracted. All had participated in the Cornell second opinion elective surgery program between 1972 and 1979. Gynecology was selected because previous analyses consistently have shown that this subspecialty has one of the highest nonconfirmation rates. Moreover, the majority of program participants follow the advice of the second opinion consultant; hence, it was deemed important to look at reasons for nonconfirmation. Findings showed that in 51% of the cases, the consultants believed either that the patient's clinical symptoms were not severe enough to warrant surgery or that further evaluation was needed. In 14.3% of the cases, no pathologic justification for surgery was evident.