Second opinion of anatomical pathology: a complex issue not easily reduced to matters of right and wrong.

Abstract

We discuss the subject of a second opinion for interpretations of anatomical pathology from the perspective of patient care. We grouped 150 cases involving pathological review at our institution into 3 categories depending on the effect on patient care. Of 29 interpretive discrepancies 14 resulted in treatment changes but 7 of these 14 may have been interpreted differently by other practice groups. Whether the second opinion represents an interpretive error or a legitimate difference of opinion, the result may affect patient care. Patients referred for treatment among practice groups should have pathological findings reviewed as part of a complete assessment by the new physicians.