Do you have doubts about your diagnosis? Are you confused about the recommended treatment and its long-term effects? Getting a second opinion from an expert might end your worries
Rabina wasn’t ready for the news. “You need surgery,” the doctor had said after looking at the results of a battery of tests. “Can’t be!” she cried. “My job, family, the expense!” She rushed home to Google for information. There was an overload, which made her feel worse. A friend recommended a local doctor, and “consulting him was hugely calming”, she says. “He made a time-table to factor in my busy life and helped me face the treatment with confidence.”
There’s proof that when a second opinion is elicited, treatment recommendations and even diagnoses are significantly altered, explains Muthukumaran Jayapaul, Arka Center of Hormonal Health, dissecting the case. Very few things in medicine are black or white, and there is a lot of significant differences of opinion among today’s specialists, he says. It can be difficult even for experts to catch up with medical advances. Yes, a second opinion is a sensible choice, but seeking it depends on whether you follow the conservative or an aggressive route to investigation and treatment.
Isn’t confusion a possibility? Definitely not, if done by an expert in the field, he says. Doesn’t it show trust-deficit in the first doctor / hospital? “Not at all,” he insists. Most of his patients are at his clinic just for an opinion, being unsure of their medical condition and advice and treatment offered earlier. Some come because they have no answers to their symptoms even after multiple visits to many hospitals, specialists and extensive investigations. “We actually recommend a medical second opinion when the treatment suggested is ineffective and the condition deteriorates or when the treatment is considered too risky or toxic, or when they are about to undergo a major surgery.”
Would the first doctor consulted like having a second medical report thrust under his nose? Some doctors have been less than kind to patients who show “lack of faith”. “A true professional will not and should not be upset or intimidated by a second opinion,” Dr. Muthukumaran says. It’s also unethical to make this a reason for denying treatment. Isn’t it a medical tradition for colleagues to pool opinions about a patient? In rare endocrine conditions, getting a second opinion from another endocrinologist is a smart move, he says. He occasionally offers it voluntarily to his patients. In fact, respect for the doctor goes up several notches when he does that, he says.
Go for it, said Riyaz Sheriff, who has set up www.medicalsecondopinion.org to streamline the process. With the medical world bursting with research and innovation, with super-specialists attending to every part of the body, we need to know of the pros and cons of every prescription. When it comes to decisions such as surgery, chemotherapy or ventilator-support, opinion from a second specialist helps patients opt for a method best suited to their health status.
The Internet is a double-edged sword for second opinion, he warns. “Authenticity depends on the source, so check if the information has been posted by an expert in the field.” A specialist’s second opinion is sufficient in most situations, but there is no harm in scouting for a third when the medical condition involves multiple systems. Any medical opinion should be correlated with clinical history, examinations and relevant laboratory tests. The idea is that the patient gets a crystal clear perspective of his / her condition, the physician chooses the best course of treatment. Dr. Riyaz adds, “The system makes doctors update themselves on the latest / best options available. It helps primary physicians in rural areas in their diagnosis and treatment.”
I visit medicalsecondopinion.org. It scrolls our questions prominently (What does the diagnosis mean? Is it correct? Is there an alternative treatment?), promises to connect experienced and authoritative experts to individuals with a medical problem or question, and asks visitors to submit medical reports to get a complete evaluation — for a fixed fee. Leading specialists will reach you, with “prompt and comprehensive replies” so you can make informed decisions about your current health. “If requested, our panel of experts will guide you to the best place for treating the condition.”
Second opinions have saved lives, made better treatment possible. Don’t let anyone ask you, “Why didn’t you go for a second opinion?”
l A second opinion might give you a fresh perspective and new information.
l It may provide you with new options for treatment.
l If you consult a physician / specialist, follow the treatment prescribed, and still don’t see any improvement, go for a second opinion.
l If you are confused and do not know if surgery is the best option, consult another surgeon.
l If the second opinion varies from that of the first specialist, consult another independent specialist.