Second Opinion

Seeking a second opinion is very important if you need to make certain or receive an accurate diagnosis and the best treatment options. A decent consultant will welcome the input of another professional. It’s important to give the exact details of your diagnosis and planned treatment to the doctor with whom you are seeking the second opinion Always make sure you have the below information and reports.
  • Copies of all your pathology findings and reports.
  • If you have had surgery earlier, a copy of the postoperative report.
  • If you were hospitalized earlier, the discharge summary.
  • A summary of your current treatment plan.
  • Details of your current medication plan and dosage schedule
When faced with complex medical treatments and options, you may seek a second opinion from another doctor, surgeon, or specialist. For better decision-making, a second medical opinion can help confirm a diagnosis or discuss alternative treatment options. Seeking a medical second opinion can assuage concerns when facing serious or life-threatening health conditions. A second medical opinion should also be sought as soon as possible after the primary consultation in order to begin appropriate medical treatment as soon as possible.
You should seek a second opinion in the following situations:
  • Your primary doctor is planning an experimental treatment option for you because you have a fatal/life-threatening condition.
  • Diagnosis is unclear, or if you have too many ailments.
  • Your primary doctor is not a specialist.
  • Current treatment is ineffective.
  • Various treatment options.
  • Introductory consultation diagnosed the condition as untreatable.
  • You need confirmation.
Start by discussing with your physician about getting a second opinion from a specialist, if not already referred. However, If you've already seen a specialist, look for someone with similar training and experience. Alternatively, you can also ask your insurance company, a local doctor, a clinic, or a hospital to recommend a specialist for a second opinion. You can also look for specialists/surgeons online to talk about your diagnosis and treatment options.
In most cases, your primary care physician should be fine with you seeking a second medical opinion. You don't require permission, but rather advice. However, inform your primary care physician that you are seeking a second opinion before beginning treatment or undergoing surgery. Generally, your primary care physician or doctor will advise you to seek expert advice from a specialist.
Second medical opinions are provided by doctors who specialise in specific organs or conditions. For example, if cancer is detected, it is recommended by general physicians or another body part specialist to consult an oncologist. They can assist you in better understanding of a medical condition's diagnosis, treatment options, and outcomes so that you can make an informed decision. They may also have experience with patients who have similar illnesses or have access to advanced surgical techniques.

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  1. People make mistakes every day, and doctors are not immune to this fact. What’s more, some doctors are more conservative while others tend to be more aggressive. So, their findings and recommendations can vary dramatically. For this reason, more and more patients are getting second opinions after a diagnosis. Whether your doctor recommends surgery, makes a cancer diagnosis or identifies a rare disease, there are many benefits to getting a second opinion. These benefits include everything from peace of mind and confirmation, to a new diagnosis or a different treatment plan.
  2. Even if your second opinion just confirms what you already know, it can still be beneficial. Afterwards, you will know that you have done everything you can to ensure that you have the correct diagnosis and a treatment plan that feels right to you. A second opinion also can offer insight into additional treatment options that the first doctor may not have mentioned. As a result, you become more informed about what is available to you and can make an educated decision about your healthcare and your treatment plan.
  3. A study conducted by the Mayo Clinic found that as many as 88 percent of patients looking for a second opinion will leave the office with a new or refined diagnosis. Meanwhile, 21 percent of the people will leave with a “distinctly different” diagnosis. Conversely, the study, which was published in the Journal of Evaluation in Clinical Practice, discovered that 12 percent of patients will learn that the original diagnosis was correct. This means that one out of every five patients they saw was incorrectly diagnosed. During the study, researchers reviewed records of 286 patients referred from primary care physicians to Mayo Clinic’s General Internal Medicine Division in Rochester. The study took place from the beginning of 2009 to the end of 2010. The factors that motivated people to get second opinions included getting confirmation of their diagnosis, being dissatisfied with a consultation, wanting more information, and dealing with persistent symptoms.
  4. A study conducted by researchers at Johns Hopkins Medicine say that medical errors should rank as the third leading cause of death in the United States, further supporting the need for second opinions. In their study, they estimated that more than 250,000 Americans die each year from medical errors, making errors the third leading cause of death behind heart disease and cancer. But they claim these errors are not accurately documented by the Centers for Disease Control.

Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct.

These findings were published online today in the Journal of Evaluation in Clinical Practice. The research team was led by James Naessens, Sc.D., a health care policy researcher at Mayo Clinic.

Why get a second opinion

When people are sick, they look to their doctor to find solutions. However, physicians don’t always have the answers. Often, because of the unusual nature of the symptoms or complexity of the condition, the physician will recommend a second opinion. Other times, the patient will ask for one.

This second opinion could lead to quicker access to lifesaving treatment or stopping unnecessary treatments. And a second opinion may reduce stress in a patient’s extended family, when they learn the new diagnosis does not carry dire genetic implications. These scenarios can result from diagnostic error.

Odds are good the diagnosis will be adjusted

To determine the extent of diagnostic error, the researchers examined the records of 286 patients referred from primary care providers to Mayo Clinic’s General Internal Medicine Division in Rochester over a two-year period (Jan. 1, 2009, to Dec. 31, 2010). This group of referrals was previously studied for a related topic. It consisted of all patients referred by nurse practitioners and physician assistants, along with an equal number of randomly selected physician referrals.

The team compared the referring diagnosis to the final diagnosis to determine the level of consistency between the two and, thus, the level of diagnostic error. In only 12 percent of the cases was the diagnosis confirmed.

In 21 percent of the cases, the diagnosis was completely changed; and 66 percent of patients received a refined or redefined diagnosis. There were no significant differences between provider types.

“Effective and efficient treatment depends on the right diagnosis,” says Dr. Naessens. “Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling ─ not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”

Risks of cost containment

To manage costs in a health care environment with ever-increasing costs, health insurers often limit access to care outside their network, effectively limiting referrals. Further, primary care providers may be more confident in their diagnostic expertise than warranted in a particular case, or patients may lack the knowledge or assertiveness to request a referral.

“This may prevent identification of diagnostic error, and could lead treatment delays, complications leading to more costly treatments, or even patient harm or death,” says Dr. Naessens. “We want to encourage second opinions when the provider is not certain.”

The National Academy of Medicine cites diagnostic error as an important component in determining the quality of health care in its new publication, Improving Diagnosis in Health Care:

Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in health care. Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity.

“Referrals to advanced specialty care for undifferentiated problems are an essential component of patient care,” Dr. Naessens says. “Without adequate resources to handle undifferentiated diagnoses, a potential unintended consequence is misdiagnosis, resulting in treatment delays and complications, and leading to more costly treatments.”

The researchers identified costs associated with second opinions, and Dr. Naessens notes, “Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly.”

He says that he and his team are pleased by the National Academy of Medicine’s call for dedicated federal funding for improved diagnostic processes and error reduction. They also plan further research on diagnostic errors and hope to identify ways to improve the process.

Dr. Naessens leads quality and safety research initiatives within the Office of Health Care Practice and Policy in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. He is also the scientific director for the Florida team within the center.

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