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When Medical Opinions Conflict

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If you’ve got a medical problem, you need to feel certain that your doctor knows what’s wrong with you and is recommending the best treatment. That’s why second medical opinions are so important—they give you a greater level of confidence that the diagnosis is accurate and/or the treatment is appropriate. If the second opinion confirms that of your original doctor, then you’ve got a green light. But what happens when your second-opinion doctor disagrees? Studies going back more than 40 years show that roughly 20% of diagnostic second opinions do not confirm the original doctor’s diagnosis. Meanwhile, when Mayo Clinic conducted a recent study focusing on second opinions sought from them, researchers found that the original diagnosis was confirmed in only 12% of the cases, and it was better defined/refined in 66% of cases.

If you’re dealing with a major diagnosis such as cancer or a complex heart problem…or have to decide between getting a risky surgery or taking a medication with potentially serious side effects, this puts a lot of pressure on you. My advice for making the right choice when medical opinions conflict…

• Find out what led to each opinion. Ask the physicians you’ve consulted to give you the reasons—including specific scientific evidence—that each doctor used to arrive at his/her opinion. The doctors should be reviewing the same evidence. If it’s a diagnostic conflict, how many other patients with similar symptoms or test results has each doctor successfully diagnosed? Unless it’s a rare disorder, the doctor should have treated at least 50 cases such as yours. If it’s a treatment conflict, what experience does each doctor have with each of the proposed treatments? I’d look for a doctor who has treated at least 100 cases such as mine…or at least 10 cases for a rare problem.

• Get a third or fourth opinion. Getting a third or maybe even more opinions may be a good idea, especially if there seems to be real conflict between the first and second opinions. Most insurance plans pay for these follow-ups. At this point, you are seeking a consensus among as many doctors as possible. When looking for other opinions, consider contacting major medical schools or hospitals with national reputations for specific conditions—for example, you can check US News & World Report’s Best Hospitals ratings. Insider tip: Many hospitals and well-known institutions, including Mayo Clinic, Cleveland Clinic, Massachusetts General Hospital and others, have highly regarded online second-opinion programs. Do an online search for such services to find out details. Note: Most insurers won’t pay for online second opinions. Prices typically range from $500 to $800.

• Ask each of the doctors providing opinions to review the other doctors’ opinions. Whenever possible, using this approach may lead to quicker agreement about what is wrong or should be done. One doctor may raise an issue the other(s) didn’t consider, such as another condition that’s mentioned in your medical history.

• Review the recommendations. Take the time to carefully go over each of the opinions. When doing this, you may want to enlist the help of your primary care doctor. Remember: The final decision is yours! But having all the relevant information will definitely make it easier for you to make the right choice.

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Source: Charles B. Inlander, a consumer advocate and health-care consultant based in Fogelsville, Pennsylvania. He was the founding president of the nonprofit People’s Medical Society, a consumer advocacy organization credited with key improvements in the quality of US health care, and is the author or coauthor of more than 20 consumer-health books. Date: September 1, 2017 Publication: Bottom Line Health
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