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Second Opinions Should Not Be Optional

Posted Feb 17th, 2009 by Trisha Torrey

In 2001, Nancy was diagnosed with Parkinson’s disease.  The tremors in her right hand were bothersome, but not debilitating.  The doctor gave her some meds to control the tremors.  Within a few months she began having headaches, so she was given yet another medication.  Over time she began suffering from fainting spells, then seizures. Each time more meds were added.

What Nancy hated even more than her symptoms was the impact her health situation had on her life.  One by one, she was forced to give up so much of what was important in her life—her teaching job, her love of bicycle rides (she couldn’t keep her balance), and eventually, the last symbol of freedom – her driver’s license.  She felt like a prisoner of her disease.

By 2008, Nancy began suffering seizures. Additional meds were added to her assortment to control them.  At that point she was taking 41 different pills a day.

While attending a movie with her sister, she began to have a seizure. Her sister called 911, and Nancy was delivered to the emergency room of her local hospital.  Since she had such a complicated history, and because the emergency room was so overcrowded, the decision was made to transfer her to a different hospital, 40 miles away. 

She had never been admitted to that hospital before.  Her doctor didn’t have admitting privileges there, and at first they didn’t have her records.  That meant she had to explain to the new doctors everything she could remember about her medical history, the names of all the drugs she was taking, and of course it was difficult to remember them all….

The doctors were incredulous. After several days of evaluation, including comparisons of tests to her records which finally arrived from her doctor’s office, they delivered the news to Nancy:  no Parkinson’s disease. She had never had it. She had been misdiagnosed.

………………..

Have you had a difficult diagnosis delivered to you?  Are you dealing with one now?

The odds are in your favor that your diagnosis is correct – but just barely. Recent studies show that up to 40 percent of all diagnoses are wrong.  That means that if you have been to a doctor 10 times for 10 different problems, the diagnosis may have been wrong four times!

Granted, it’s unusual for a diagnosis to get as out-of-hand as Nancy’s did.  The tremors were indicative of Parkinson’s, but ensuing symptoms like fainting and seizures were not.  The problem was, when those new symptoms began to appear, her physician would have had to admit that he had been wrong in order to pursue new avenues to a more accurate diagnosis.  That rarely happens.

 

So how are we supposed to know whether our diagnosis is correct?  It’s our responsibility to figure that out. 

Often that will require a second opinion. Surprisingly, fewer than one-third of patients who are dealt a difficult diagnosis ever seek a second opinion. But as you can see from Nancy’s story, it can make a huge difference in your outcome.

First piece of advice for a second opinion – find a second opinion doctor on your own.  Do not ask for a referral from your current doctor because he will not send you to someone who can look at your situation with fresh eyes.  Think of it this way – if your auto mechanic couldn’t fix your car, would you ask him to refer you to someone who could?

Once you find that second opinion doctor, make sure she has all the same evidence to review as your first doctor. Provide copies of your previous records and any test results available.

A second opinion will result in one of three outcomes. Both doctors may agree on your diagnosis and treatment recommendations. In that case, choose the one you prefer to work with, especially if your diagnosis will mean ongoing treatment.

The second doctor may agree with the diagnosis, but provide you with a different treatment option. That will require some research on your own to learn everything you can about your treatment choices.  Choose the doctor who suggests the treatment option you prefer.

Or it could be that there will be disagreement on the diagnosis, in which case there will probably be disagreement on the treatment options, too.

If your doctors differ in their assessments of your situation, there are some thoughts to keep in mind:

Let’s start with some "don’ts."

  • Don’t assume that the doctor who gives you better news is the correct one. Just because you like the answers better doesn’t mean she is right.
  • Don’t assume the second doctor is correct. If the second doctor’s opinion is always the correct one, why did you go to a first?
  • Don’t assume that the "nicer" doctor is right either. A doctor with better bedside manner isn’t necessarily a better practitioner.

Here is what you should do in a case of differing medical opinions.

  • If the doctors’ opinions are very different, you’ll want to consider getting a third opinion. The third opinion will likely be similar to either doctor #1 or doctor #2, and that will help you make your treatment decisions, too.
  • If the doctors are only shades apart in their opinions and recommendations, ask them to discuss your situation with each other. Ask the doctor you prefer to work with to report back to you.  This may not work – it’s difficult to get two specialists, in particular, to talk to each other.  But it’s worth asking.

Finally, let your intuition help. Don’t discount its ability to help you judge which doctor can be more helpful to you, or which one has made a better assessment of your health. It’s your body. Let your intuitive mind work in your favor, too.

If Nancy had gotten a second opinion, if she had trusted her intuition, and if she had pursued additional information, she would not have lost seven years of her life.  Take responsibility for confirming your diagnosis.  The risk of not getting a second opinion can mean a world of difference.

And by the way.  Nancy is driving again.  She’s getting her life back.  A life she may never have given up if she had gotten a second opinion.

 

About the author

Trisha Torrey is Every Patient's Advocate. She is a newspaper columnist, radio talk show host, national speaker, and the guide to patient empowerment at About.com.

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