15 December 2015

Get A Second Opinion. It Can Save Your Life.

Medical misdiagnosis is a major problem for America’s healthcare system. In a 2015 report, the Institute of Medicine estimated that 12 million Americans are on the wrong end of a diagnostic error every year. Most of us will be misdiagnosed at least once in our lifetime, and those mistakes have real consequences for our health and well-being.

Statistically speaking, you will be misdiagnosed at some point, if you haven’t been already. That’s not alarmist, it’s the truth. But there’s a simple, effective way to reduce your risk of being misdiagnosed: seek a second opinion. Some hospitals, including the world-renowned Cleveland Clinic, have even begun offering second opinion services online – though the virtual outside eyes can come at a hefty price.

Infographic: The Importance Of Obtaining A Second Opinion

The Importance Of A Second Opinion On Cancer Diagnosis

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How To Get A Medical Second Opinion

Getting a second opinion is surprisingly easy, especially in the digital age, but lots of patients fear offending their primary care physicians (PCP). Chances are that next appointment won’t be awkward, even if you do ask for a referral to a specialist. Asking your doctor for an outside eye isn’t going to start a war.

 

In fact, doctors usually value second opinions as much as patients do, because they work. In a study of patients who sought out second opinions after being diagnosed with breast cancer, researchers from the Netherlands found that one-third of the second opinions (all of which were initiated by patients) disagreed with the diagnosis of a primary care physician. For 16% of those patients, their second, more accurate diagnosis led to a significant change in both treatment options and prognosis.

In other words, second opinions save lives. Here’s how to get one:

Ask For A Referral

If you were diagnosed by your PCP, ask them to refer you to another doctor who specializes in the condition. It’s likely that your physician will be able to send your medical records and any test results over, so getting a second opinion could be as simple as sitting down with another doctor for a conversation.

Make sure you visit a physician at a different practice. Jerome Groopman, MD over at WebMD, insists on this point: “Institutional cultures are real, and often an opinion leader at one hospital will do things a certain way and others at that instution will conform to that viewpoint. But at another hospital, even across town, there may be a very different philosophy.”

Use The Internet – Intelligently

If you can’t find a specialist in your area, try one of the many e-second opinion services offered by hospitals like the Cleveland Clinic. You’ll need to collect your medical records, which can be difficult and frustrating, but once you’ve sent them away you should receive an independent report in no time.

Online second opinions can be costly. At the Cleveland Clinic, a second opinion will run you $565, unless you need a pathology review, in which case it can be as high as $745. 8 departments at Johns Hopkins, including pathology and surgery, also offer their own online second opinion programs. The costs are almost identical to those at the Cleveland Clinic.

Be aware that second opinions, from anyone, will vary in cost based on the condition being investigated. The more doctors have to work, reviewing old test results or ordering new diagnostics, the higher the final sum will be.

There are also several private companies (not recognized hospitals) offering online “second opinions.” The aptly-titled SecondOpinions.com is one. These companies work through medical consultants, essentially ferrying medical records between patients and (usually) licensed experts. Many of these services are advertised as less expensive than programs like the one at Cleveland Clinic. SecondOpinionExpert gives second opinions out for $300, with an additional fee of $200 if you want to video chat with the doctor who reviewed your records.

Will Insurance Cover A Second Opinion?

That depends on your insurer and policy. States like California and New York have passed laws guaranteeing HMO members the right to a second opinion, but you’ll need to check with your insurance company to know.

E-second opinions are rarely covered by insurance, and the Cleveland Clinic doesn’t accept insurance payments as a rule.

Whether or not they do cover second opinions, it’s probably in an insurance company’s best interests to cover them. Why pay for a $50,000 procedure when a less expensive treatment may be possible, just unidentified?

Are Americans Too Confident In Their Doctor’s Opinion?

It’s almost strange to say that doctors have opinions at all. Many of us assume that, like science, a physician’s pronouncements are blind, impersonal statements of fact. But of course, they’re not. Neither is science for that matter. Both are subject to errors and biases; both benefit from experience, but for that to be true, mistakes have to be made.

Most Americans, however, seem to approach their doctor’s as infallible sources of medical knowledge.

In 2010, a Gallup poll of 511 randomly-selected adults found that 70% of respondents were “confident in the accuracy of their doctor’s advice.” Only 29% felt it was necessary to seek a second opinion, or do any research on their own. That confidence seems to be growing over time. Gallup conducted an identical poll in 2002, but only 64% of respondents said they were confident in their physician’s opinion.

There is one area of medicine, however, in which patients overwhelmingly seek out advice from a second, third or even fourth doctor: cancer. Surveys suggest that more than 50% of patients get a second opinion after receiving a cancer diagnosis, which isn’t hard to explain when you recognize that around 30% of initial cancer diagnoses may be plain wrong.

What If My First Doctor Was Wrong?

That depends on how your doctor’s mistake has affected your life. Many patients suffer considerable harm from a diagnosis. Some people, misdiagnosed with cancer, undergo agonizing (and extraordinarily costly) treatments like chemotherapy – only to learn later that they don’t have cancer. For these patients, filing a lawsuit may be the only way to regain a fraction of what they’ve lost.

People who were misdiagnosed, but didn’t suffer any demonstrable losses, probably won’t have grounds to file a medical malpractice claim. For them, the confidence of knowing that a second doctor got it right might be enough.

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