I got this in a newsletter and thought I'd share because it's an important
message:
It's Good to Second-Guess Your Doctor
My friend was recently diagnosed with breast cancer, and
told by her doctor that she should have a mastectomy. Yet
rather than rush to have surgery, she is seeking a second
opinion... a very good idea. A new study has found that a
second opinion from a team of specialists after an initial
diagnosis of breast cancer resulted in a significant change
in treatment protocol in more than half of the cases... and
six of the women were found not to have breast cancer at
all! This study underscores what many medical experts have
been telling us for years -- getting a second opinion for a
major medical problem is one of the most important things
you can do to protect your health and life.
In the study, 149 patients diagnosed with breast cancer
were referred to a breast cancer clinic at the University
of Michigan Comprehensive Cancer Center, where a
multidisciplinary review board consisting of oncologists,
surgeons, radiologists, pathologists, radiation oncologists
and nurses reviewed and discussed the patients' medical
information including mammograms, biopsy slides and their
referring surgeons' treatment recommendations. This second
evaluation of these patients led to changes in the
recommendations for surgical treatment in 77 patients
studied (52%). The specialists had differing opinions
regarding everything from the interpretation of the
patients' mammograms to the necessity for mastectomy.
"We certainly expected that there would be some impact
on these cases from the multidisciplinary review board, but
we were surprised that more than half of the patients had
some kind of change in their management," said Michael
S. Sabel, MD, study coauthor and a surgical oncologist at
University of Michigan Comprehensive Cancer Center.
The study supports the growing body of evidence that second
opinions can provide patients with critical information
when making difficult treatment decisions. "I
encourage patients to get a second opinion," said Dr.
Sabel. "Patients need to know what their choices are.
There may be new treatment approaches to consider, or they
may find that the diagnosis is entirely wrong, as was the
case for some patients in this study."
FINDING THE BEST TREATMENT
The study's findings come as no surprise to Mehmet C. Oz,
MD, who is a professor of surgery at Columbia University
Medical Center in New York. He emphasizes the importance of
getting a second opinion in his bestselling book, You: The
Smart Patient: An Insider's Handbook for Getting the Best
Treatment (Free Press). He told me that overall, not just
with breast cancer, "research has shown that getting a
second opinion results in new diagnoses in as many as 30%
of all cases."
http://link.dhn.bottomlinesecrets.com/t/9Y4S/0Z6I/ZH/KFZU1
However, in spite of the apparent value of second opinions,
few people get them. "Only 20% of people who seek
medical care every year get a second opinion," said
Dr. Oz. "Many people are embarrassed about it or they
don't want to offend their doctors."
Always seek a second opinion if...
*Your doctor says you need surgery.
*Your doctor is stumped by your condition and can't
diagnose it.
*Your doctor isn't a specialist in the disease you have.
*Your treatment isn't working.
*Your doctor doesn't seem to be taking your symptoms
seriously.
*You want to try other treatment options.
*A serious diagnosis has been made (to confirm its
accuracy).
You should also get a second opinion if you are taking
several medications simultaneously, Dr. Oz told me, noting
that "a recent study showed if you're on six or more
medications, the chance of having a drug interaction is
94%. This means if you're on more than six drugs, you'd
better get a second opinion about them."
HERE'S HOW TO DO IT
Not only will most insurance companies cover second
opinions, since it makes financial sense, many insurers
actually require one before they'll pay for certain major
procedures. Medicare typically covers most or all of the
cost for second opinions for important treatments such as
surgery. (Note: Some Medicare managed care plans require a
referral from your primary doctor prior to the visit.)
HMOs usually will pay for second opinions from doctors who
are in the plan's network. And, more and more often, cancer
centers automatically review cases with a multidisciplinary
tumor board, making second opinions routine for their patients.
Once you've decided to get a second opinion, learn as much
as you can about your medical problem. According to Dr. Oz,
patients who do their homework use their appointment time
more productively and are better able to make decisions
regarding their treatment. Internet Web sites, such as
www.nlm.nih.gov/medlineplus, www.cancer.gov or
www.healthweb.org -- and our own Bottom Line archive of
information at www.bottomlinesecrets.com -- can provide a
wealth of useful health information, research and
resources. Also, says Dr. Oz, "the Internet is a
great way to find top experts in a medical field. Many
people don't know that they can research academic papers
that are written by health experts in their field, and find
out where the authors of these papers are from. Even if
they don't live nearby, these experts can always refer you
to someone who does live near you." Another good
source for referrals is Castle Connolly Medical Ltd., a
health information resource company that researches and
makes available lists (www.castleconnolly.com) of the
country's most highly regarded physicians in every specialty.
Once you find a doctor for a second opinion, ask what you
should bring to your appointment, which may include all
relevant X-rays, test results and reports. It is also a
good idea to make a list of questions ahead of time, and to
bring a friend or relative along for moral support and to
listen to what the doctor is recommending, which may be a
great help afterward.
VIRTUAL SECOND OPINIONS MAY BE AN OPTION
If you'd rather consult with a doctor without leaving the
comfort of your home or if the best doctor to meet with is
very far away, several Internet Web sites (sponsored by
private organizations, medical universities and hospitals)
offer second opinions for a small fee, such as Cleveland
Clinic, http://eclevelandclinic.com/cms/myconsult.html. You
submit your X-rays or test results to specialists who
review them and send an opinion back to you via e-mail.
Although this approach can provide you with additional
information, Dr. Oz believes it does not compare with a
face-to-face meeting with a doctor. "It's hard to
believe that someone who is sitting across from you and
knows the nuances of your case wouldn't be a much better
choice," he said, adding "but it is better than
doing nothing."
Of course, in the event that there is a real difference of
opinions, you may need a third opinion, says Dr. Oz. Some
insurance plans will pay for it -- but if not, this may be
an occasion when it makes sense to dig as deeply as you
need to for the real, right answer.
Source(s):
Michael S. Sabel, MD, assistant professor of surgery at
University of Michigan Health System. Dr. Sabel is
coauthor of the new University of Michigan Comprehensive
Cancer Center's study "Changes in Surgical Management
Resulting from Case Review at a Breast Cancer
Multidisciplinary Tumor Board," which was published in the
November 15, 2006 issue of the journal Cancer.
Mehmet C. Oz, MD, is professor of surgery at Columbia
University Medical Center and attending surgeon at New York
- Presbyterian Hospital. He is also director of the
Cardiovascular Institute. He is coauthor, with Michael F.
Roizen, MD, of You: The Smart Patient: An Insider's
Handbook for Getting the Best Treatment (Free
Press).