Second opinion before surgery

What is a second medical opinion?

Photo of a couple talking to a doctor in a hospital

In Germany, people have a legal right to a second medical opinion for certain non-urgent operations. That means doctors who recommend one of those operations must tell their patients that they have a right to discuss whether to have surgery or not with another specialist at no extra cost.

This right applies to the following types of surgery:

  • Hysterectomy
  • Tonsil surgery
  • Shoulder arthroscopy
  • Knee replacement
  • Amputation due to diabetic foot syndrome
  • Spine surgery

Some health insurance providers also offer their members a consultation with an additional specialist, for example for operations on the spine, knee and hip.

When is a second opinion a good idea?

A lot of illnesses can be treated in more than one way. Often, none of the alternatives is ideal, and they each have their pros and cons. The best choice for you depends very much on your personal situation and your own preferences. Speaking to a second doctor can help when making a decision.

And comparisons have shown that different doctors can have very different opinions about the operations covered by the right to a second medical opinion. Some are quick to recommend surgery, others less so.

Some patients are reluctant to question doctors' recommendations. The second medical opinion procedure aims to make sure that all patients have the chance to make an informed decision in their own time.

How do I get a second opinion?

If one of the procedures listed above is recommended to you, the doctor normally has to tell you about your right to a second medical opinion at least ten days before the planned operation. The Federal Joint Committee (G-BA) has a leaflet with detailed information about your right to a second medical opinion.

If you feel you have enough information and don't have any further questions, you needn't do anything. The second opinion is a voluntary offer that you don't have to make use of.

If you would like a second medical opinion, you can find a list of the doctors you can contact for that on the internet. You can also ask your health insurance provider about suitable specialists.

People with statutory health insurance in Germany can choose their doctor freely. That is why you fundamentally always have the option of asking more than one doctor for advice about a health problem. The advantage of the second medical opinion procedure is that the doctor giving the second opinion has to have special qualifications. What is more, they aren't allowed to work in the same practice or hospital as the first doctor. And they aren't allowed to work at the hospital where the operation will be done.

Once you have found a doctor for a second opinion, make an appointment.

Will I be examined again?

The doctor needs any documents you have so far, such as medical reports and test results. You will be told which documents you need when you make the appointment. You can ask to take the medical reports with you at your first doctor's practice. Or have them sent directly to the second doctor. Both options are free of charge.

Generally, the second doctor will not examine you again; rather, they will read your file and ask any further questions they might have. The doctor will talk to you if they think further examinations would be a good idea.

What do I do with the second opinion?

The second doctor will discuss the recommendation with you. You are free to choose which treatment you think is best for you, so you can also cancel any operation appointments you might have already made. You may also request a written summary. You can have the recommendation sent to your first doctor.

You can find various decision aids to help you make a decision in our "Learn more" section.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Created on July 5, 2022
Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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