Second opinion process for tonsillectomy and tonsillotomy: analysis of the quantitative and qualitative justifying conditions

Background In 2017, the Federal Joint Committee determined tonsillectomy and hysterectomy in non-oncologic diseases as well as tonsillotomy for second opinion procedure. We discuss the suitability of tonsillectomy and tonsillotomy for the second opinion procedure on its quantitative and qualitative characteristics. Materials and methods Data from the Federal Statistical Office concerning numbers of cases were evaluated. Numbers and regional distribution of ENT-specialists providing second opinion were analyzed by websites of Associations of SHI Physicians. Results Between 2005 and 2018a significant decrease in tonsillectomy cases from 119808 to 42548 is observable that is by far not compensated by increasing tonsillotomy numbers from 4659 (2007) to 18369. At the same time, surgical procedure rates at regional levels remain volatile. 218 ENT-specialists in 142 towns provide second opinion. On basic of case numbers in 2018a relationship of 1(ENT-specialist): 280 (tonsillectomy/tonsillotomy patients) results (range from 1:90 to 1:800). Conclusions On the background of decreasing surgical rates tonsil surgery does not comply with the requirements of second opinion procedure. Reachability of second opinion providers is difficult in many regions, such compromising a compensation of different levels of surgery. As a result of our investigation we recommend scientific supervision of currently second opinion procedures and a survey of actual demand from the patient's viewpoint.

Automated summary

The study found that tonsil surgery, with decreasing surgical rates, is not suitable for second opinion procedures. Additionally, in many regions, it is difficult to find doctors who provide second opinions, compromising the compensation for different levels of surgery.