The Value of a Second Opinion at the Mayo Clinic

Joe Graedon jgraedon at GMAIL.COM
Sat Apr 8 22:24:21 UTC 2017


I encourage everyone to go back and read George Lundberg's thoughtful article "Low-Tech Autopsies in the Era of High-Tech Medicine: Continued Value for Quality Assurance and Patient Safety." George was editor-in-chief of JAMA at the time. That was 1998. 

George pointed out that since the 1930s approximately 40% of the time the diagnosis that was made before death was different from that revealed by autopsy. 

A NYT article from 2006 noted that "studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time..."

I find it interesting that autopsies have pretty much gone the way of the buggy whip...but the 20% figure (see the recent Mayo study on 2nd opinion) resurfaces. 

When will patients and their families be included in this process in a meaningful way and when will modern medicine embrace Larry Weed's vision?

Will a new generation of health professionals still be having this conversation 60 years from now?

Joe 

Sent from my iPad

> On Apr 5, 2017, at 3:49 AM, Bridget Kane <kaneb at TCD.IE> wrote:
> 
> One of the questions for me is β€œare we assuming that the second opinion is the gold standard?”
> Or how can we identify the truth, i.e. the correct diagnosis?
> 
> Is there a stronger placebo effect following a second opinion, I wonder?
> 
> Does anyone have any research on this, by chance?
> 
> Thanks
> 
> Bridget 
>> On 4 Apr 2017, at 16:02, Mark Graber <Mark.Graber at IMPROVEDIAGNOSIS.ORG> wrote:
>> 
>> Just coming out – this study from the Mayo Clinic finds that 20% of referred patients end up with a very different diagnosis.  The findings are very similar to the results from the second opinion program at Best Doctors, as referenced in the Mayo Clinic article.  In both cases, however, these are not randomly selected patients being studied – they are patients who were concerned enough about their initial diagnosis (or lack thereof) to seek out the second opinion.
>>  
>> Mark
>>  
>> Mark L Graber MD FACP
>> President, SIDM
>> Senior Fellow, RTI International
>> Professor Emeritus, Stony Brook University
>> <image001.png>
>>  
>> 
>> 
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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