Alessandra Fruci, a mother of two living outside Toronto, knew something wasn’t right when her optometrist dismissed her young daughter’s eye problems. “She was squinting,” says Fruci. “A month and a half later, she started crossing her eyes.” But when Fruci and her husband brought Erica, then age two, to the optometrist for several visits, they were told, “No, she’s fine.’”
Undeterred, Fruci asked her pediatrician to refer her to a pediatric ophthalmologist for a second opinion. There it was revealed that Erica has strabismus, a condition in which the eyes are misaligned and have trouble focusing. She also was extremely farsighted. A pair of glasses solved the problem, and today Erica is a happy, thriving four-year-old.
The experience has taught Fruci to trust her instincts. “If something isn’t quite right, you should pursue it,” she says. “You won’t be sorry in the end.”
Mistakes can happen
Dr. Sholom Glouberman knows this all too well. He’s the president of Patients Canada, a patient-led organization formed to help bring the voice of patients and caregivers to healthcare in Canada and an assistant scientist at Baycrest, a research institute that focuses on aging and neuroscience in Toronto. He himself went for a second opinion after a test detected a precancerous condition in his colon. “It does make a difference to confirm a diagnosis,” says Glouberman. In his case, the second consultation confirmed the need for surgery.
Glouberman says patients are sometimes hesitant to ask for a second opinion because they don’t want to appear to be second-guessing their doctors. And some doctors feel like a second opinion challenges their authority. “There are a lot of feelings involved,” he acknowledges.
That said, the old-school, authoritarian approach to medicine that was popular in the past - where patients never questioned their doctors’ decisions - is changing. “People are taking more responsibility for their healthcare,” says Glouberman. But he suggests patients not second-guess every diagnosis - just serious diseases and chronic conditions such as cancer or chronic obstructive pulmonary disease.
If you are still jumpy about requesting a referral for a second opinion, consider that statistics show the decision could be life-changing. A 2004 study on adverse events among hospital patients in Canada published in the Canadian Medical Association Journal found that 9,000 to 24,000 people die annually from preventable adverse events - unintended injuries or complications caused by health care management rather than the actual disease - some stemming from faulty diagnoses or treatment.
And a 2006 study on the discrepancy between second and first opinions in surgical oncological patients published in the European Journal of Surgical Oncology found that “one-third of patient-initiated second opinion consultations resulted in a discrepancy with the first opinion.”
It’s because of research like this that the Canadian Medical Association includes the following in its CMA code of ethics: “Respect your patient's reasonable request for a second opinion from a physician of the patient's choice.”
While the best route to a second opinion can be to ask your family physician for a referral to another doctor or to ask your specialist to order a second look at your pathology results, you might be in for a wait. But other options exist: A number of private firms have set up shop offering a second opinion if a patient is seeking one:
- Best Doctors is one such organization. Its services are covered under many employer-sponsored benefit plans and it provides access to 53,000 medical specialists globally.
- Medical Second Opinion provides access to medical specialists at McGill University Health Centre via private health insurance plans upon diagnosis of a serious medical condition.
Fruci certainly won’t hesitate next time she’s unsure about a diagnosis. “I trust my gut. If something doesn’t feel quite right, I have to get a second opinion.”
Three things to do if you have concerns about your diagnosis:
- Find out if you have access to a second opinion as part of your benefits coverage.
- Talk to your pharmacist if you’re worried about medication you've been prescribed.
- Follow your instincts if your body is telling you one thing and your doctor another.