2nd Opinions

Mark Graber Mark.Graber at IMPROVEDIAGNOSIS.ORG
Tue Mar 5 01:27:54 UTC 2019


YES YES YES  - Fresh eyes catch mistakes.  Obtaining a second opinion may be one of the most effective interventions we have to address diagnostic error.  Second opinions have been extensively studied in radiology and pathology, including some studies that included longer-term follow-up to see if the second opinion was actually correct.  There IS a finite error rate with the second opinion as well, but by combining the two your odds of getting the correct answer clearly improve.  A large number of diagnoses change with a second opinion in general medicine too – see the attached review and article.  The Mayo Clinic, the Cleveland Clinic, and many others have been providing this kind of service for years – the Mayo cites a 20% rate of changing diagnosis, which is very much in line with our literature review and study of the second opinions provided by “Best Doctors”.

There may also be value in the ‘STOP AND THINK’ approach – ie getting a second opinion from yourself ;<)   No data on that option yet, but it seems plausible.

Mark

Mark L Graber MD FACP
Chief Medical Officer; Founder and President Emeritus, SIDM
Professor Emeritus, Stony Brook University, NY
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“This is a second opinion. At first I thought you had something else”.

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From: Io Dolka <iodolka at GMAIL.COM>
Reply-To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, Io Dolka <iodolka at GMAIL.COM>
Date: Monday, March 4, 2019 at 4:20 PM
To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] 2nd Opinions

Dear SIDM friends and colleagues,

Would you have any tips, advice or pointers regarding the issue of 2nd opinions?

I will be giving a webinar next month at www.washaa.org<http://www.washaa.org> on the topic, geared towards professional patient advocates, nurses, social workers, and the general public.

Is there a point of view worth talking about that is hardly ever addressed? Any pointers on the various areas covered would be greatly appreciated:

1) Data/studies on effectiveness, diagnosis or treatment plan change after 2nd opinions,
2) When to seek (and when not to seek?) a second opinion
3) How to select another provider for a second opinion
4) Second opinion companies, their pros and cons as a resource
5) Insurance issues with second opinion visits, diagnostics, etc.

If you prefer a quick phone call instead, please let me know.  You can email me directly if you prefer.

Many thanks in advance for your help!

Io


Io Dolka, MS
GreyZone, LLC - Managing Director & Chief Care Advocate
SIDM-Patient Engagement Committee Member

Direct: 206.355.1285  |  Email: iodolka at gmail.com<mailto:iodolka at gmail.com>
[vcs]

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Name: Payne et al - 2014 - Patient-initiated second opinions - Systematic reivew of characteristics and impact on diagnosis, treatment, and satisfaction.pdf Type: application/pdf Size: 538458 bytes Desc: Payne et al - 2014 - Patient-initiated second opinions - Systematic reivew of characteristics and impact on diagnosis, treatment, and satisfaction.pdf URL: <../attachments/20190305/34aa23fc/attachment.pdf> ATTACHMENT:
Name: Meyer ... Graber - Evaluation of outcomes from a national patient-initiated second-opinion program.pdf Type: application/pdf Size: 567188 bytes Desc: Meyer ... Graber - Evaluation of outcomes from a national patient-initiated second-opinion program.pdf URL: <../attachments/20190305/34aa23fc/attachment-0001.pdf>


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