November 23, 2018

Should you get a second opinion on your medical diagnosis?

By Anna Sharratt

If you have concerns about your medical diagnosis or treatment plan, don’t be afraid to talk to another physician to get the answers you need.

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 had 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 happy and thriving.

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.”

When should you get a second opinion?

Dr. Sholom Glouberman knows this all too well. He’s the founder of Patients Canada, a patient-led organization formed to help bring the voice of patients and caregivers to healthcare in Canada, and Philosopher-in-Residence at Baycrest Health Sciences, 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.

Why would you need a second opinion?

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 health care,” 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 2016 report, Measuring Patient Harm in Canadian Hospitals, by the Canadian Institute for Health Information, found that one in every 18 hospitalizations in Canada results in harm to the patient. “Harm” in this instance refers to unintended injuries or complications caused by health care management rather than the actual disease, leading to a longer stay in hospital, disability or death. While there are a host of contributing factors, many of these incidents stem from faulty diagnoses or treatment.

And a 2014 study on patient-initiated second opinions published in Mayo Clinic Proceedings  found that “10% to 62% of second opinions yield a major change in the diagnosis, treatment, or prognosis. A larger fraction of patients receive different advice on treatment than on diagnosis.” 

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.”

How to get a second opinion

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 faster path to a second opinion if a patient is seeking one.

Teladoc Medical Experts is one such organization. Its services are covered under many employer-sponsored benefit plans as well as some individual health insurance plans, such as critical illness insurance and personal health insurance offered by Sun Life, which provides the service to policyholders and their immediate families. Teladoc Medical Experts gives its clients access to more than 50,000 medical specialists in more than 450 specialties and subspecialties, globally.

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.”

3 things to do if you have concerns about your diagnosis:

  1. Find out from your workplace benefits provider (for coverage at work) or your advisor (for individual insurance) if you have access to a second opinion as part of your health insurance coverage.
  2. Talk to your pharmacist if you’re worried about medication you’ve been prescribed.
  3. Follow your instincts if your body is telling you one thing and your doctor another.

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