Patients learn every day that they have conditions that change their lives. Millions receive life-threatening diagnoses of cancer or are advised to have invasive and dangerous surgical procedures. Many of them would never second-guess their doctor’s diagnosis, treatment nor think of seeking a second opinion. According to a recent Mayo Clinic study (1), these patients could be putting their health at risk.
In the study it was found that patient initiated medical second opinions led to major changes in diagnosis, treatment and even prognosis in 10 to 62 percent of cases. Out of this group some want a diagnosis or treatment plan confirmed. Others seek another medical second opinion when their symptoms don’t get better with their physician’s treatment. Others simply want a desire for more information or aren’t happy with their physician. Patients are even more likely to get a medical second opinion if their treatment choices are risky, complicated, or unpleasant, the study found.
Since the advent of the internet, patients have become much more active in their medical care. Many often research conditions and treatments before they see a doctor, ready with questions about treatment options or side effect. However despite this trend many patients are overwhelmed by the number of doctors they visit, their varying opinions, and the minimum time spent explaining their options.
Patients can safeguard their health by not being afraid to question their options and results. A study out of University of Texas Medical School (2) reported that diagnostic errors occur in 12 million Americans every year. Half of those errors can lead to potentially severe and harmful results. This was particularly true in patients with lymphomas, sarcomas, and cancers of the brain, skin, and female reproductive tract.
Suggestions for obtaining the best care possible:
1. If faced with a serious condition such as cancer diagnosis, rare disease or complex surgical procedure consider obtaining a second or even third opinion in an academic medical center with expertise in the area of interest. Academic centers often sub-specialize to a greater degree. This means you are more likely to find an expert doctor or researcher in that specific area.
2. Don’t underestimate the importance of the medical center’s technology, devices and equipment used for diagnosis and treatment. Newer and more advanced radiology equipment, robotic surgery or other minimally invasive procedures could make the world of difference in the care you receive.
3. A large part of the diagnosis of any condition relies on what is seen on imaging studies (i.e. X-rays, CT and MRI scans). So not only is the radiology device or technology important but also the level of experience of the radiologist. Having two radiologist review the same films may lead to a completely different diagnosis. You can do this by keeping your own records or CD’s when you obtain a medical second opinion.
4. Equally important is the evaluation of tissue biopsy specimens. Different pathologist may differ in opinion and this of course may lead to a different diagnosis and treatment all together. This is particularly important in cancer cases. You can request copies of slides to be made by the pathology department when obtaining your medical second opinion.
1. Velma L. Payne, PhD; Hardeep Singh, MD, MPH; Ashley N.D. Meyer, PhD; Patient-Initiated Second Opinions: Systematic Review of Characteristics and Impact on Diagnosis, Treatment, and Satisfaction. Mayo Clin Proc. 2014;89(5):687-696
2. Hardeep Singh, Meyer AN,Eric J Thomas. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014 Sep;23(9):727-31. doi: 10.1136/bmjqs-2013-002627.