Millions of medical tests, procedures and operations are performed every day in our country and abroad. Most of them are indeed necessary for the health of patients. However, according to regular statistical data, a small percentage of these procedures are performed unnecessarily.
The rapid development of laboratory technology has made it possible to perform numerous subtle tests. However, despite the seeming appeal of a comprehensive examination, 2-3 examinations instead of 6-10 prescribed ones are sufficient to diagnose a typical disease. Due to the development of diagnostic equipment, it has become possible to examine internal organs not only from the outside, but also from the inside, penetrating into the hollow organs. All this is delightful and tempting, but a competent clinician can do without such expensive studies in a number of cases. The fantastic development of operative techniques and their widespread introduction into practice has led to a situation where patients visiting a surgeon have the impression that surgeons only aim to operate on everyone.
Thus, the explosion of possibilities in medicine has generated a wide variety of medical opinions and recommendations. In order to somehow regulate this issue ministries of different countries create protocols that standardize approaches to treating patients. This does not mean that the doctor acts according to a template. These protocols protect the patient and the state budget from inappropriate research and unjustified treatment. In some cases, the insurance adjuster is also standing up for his or her interests and those of the patient. However, even when acting within the protocol, doctors sometimes give completely opposite recommendations.
What should a patient do in such a situation? For several decades in the whole world patients have been actively visiting doctors to get a second opinion. In our country there is also such a practice, but it is only now beginning to be talked about openly. On the one hand, patients who visit another doctor feel a sense of guilt and embarrassment. On the other hand, some doctors, when they learn that their opinion has been questioned, become enraged, which sometimes leads to a complication of relations. However, the patient's right to comprehensive information has not been abolished in our country. In the United States, for example, the right to "Second opinion" consultations is considered one of the "sacred cows of America".
The need for a second opinion arises in the following cases.
- A doctor recommends surgery.
- A doctor diagnoses a serious illness that is
a surprise to the patient and the patient refuses to believe it.
- The doctor prescribes a treatment that the patient disagrees with.
- The doctor denies a disease that the patient is convinced of.
- The patient suspects that his doctor has a commercial
interest.
- The doctor takes the initiative to recommend a second opinion.
Let us imagine a situation where a patient is recommended for surgery for a precancerous disease of the cervix that was not bothering her and was discovered by chance. Obviously, the patient will want a second opinion. The other specialist recommends medication instead of surgery. What will the patient do?
Option A - follow the recommendations of the first doctor.
Option B - follow the second doctor's recommendations.
Option C - go to a third specialist.
On the one hand, you can go around in circles like this endlessly. On the other hand, as a result of several consultations, as a result of reading the literature and getting comprehensive information, the patient will make a decision that best meets her condition and needs. A consciously made decision will create a favorable psycho-emotional mood. Each of options A, B, or C will be valid. The advantage in this case is that the patient has a choice. And the one who wants, can use this choice.
Second opinion counseling is welcomed by medical professionals around the world for two main reasons. Firstly, the principle of one head is good and two heads are better. Secondly, in this way, the patient's right to receive the most complete information with the involvement of a large number of specialists is realized.
Just as two cooks prepare the same dish with some differences, two doctors will treat the same disease with some differences. A surgeon with an active tactic will take the patient straight to the operating room. The other more conservative surgeon will recommend surgery only in an exceptional case. Just because surgeon A recommends surgery and surgeon B does not recommend it does not mean that one of them is a bad surgeon. They are simply offering different opinions and treatment options. Tactics can be proactive, tactics can be wait-and-see. Of course, we are not talking about conditions where surgery is absolutely necessary. Unfortunately, the confused, sometimes desperate patient does not always understand this. The approach of doctors to treatment and communication with the patient varies. Some specialists will go to great lengths to establish a diagnosis and work hard to clearly explain their position to the patient. Others do not bother to elaborate on their conclusions and recommendations, causing frustration and annoyance to the patient.
The purpose of this article, is to make the general public aware of the need for discussion with the physician. The patient should not feel guilty when consulting for a second and een opinion.
Below are tips for those who have the need for second opinion counseling.
Don't worry or feel guilty. Many people worry about their doctor's reaction. In fact, a knowledgeable professional understands the value of a second opinion and will welcome your desire for one. Tell your doctor your intentions, and if he or she objects, mentally flag it with a red flag. This may mean that your doctor is either not a confident professional or does not respect your right to be broadly informed.
Ask for copies of your test results and report. Get copies of the tests you had done when you went to your first doctor. This will keep you from duplicating tests. The report, which includes the diagnosis of the disease and recommendations, is necessary to avoid misunderstandings. Patients do not always give accurate information about themselves. Most medical centers keep the results of tests and examinations in files. You have every right to receive copies of these results. Request all these documents in advance, as it sometimes takes a few days to process them properly.
Consider new prospects. Contact someone who is not affiliated with your doctor. Specialists who work in the same system often think alike. If the doctor who issued the first opinion himself offers you a specialist for a second opinion, tell him, "Thank you! No". Because your goal is to get the most objective consideration of the issue. Doctors have a tendency to refer patients to their acquaintances, friends. They may have lunch together or be members of the same golf club. And doctors, like all people, tend not to be at odds with their acquaintances. Listen to the recommendations of your friends, your loved ones. Seek a specialist for a second opinion on your own.
Have a chaperone with you. If you feel tense and not collected enough, take a loved one with you. In a state of anxiety, a person may perceive information with a certain distortion.
Request a review of the histologic report. This item refers to the report on malignant pathology. The diagnosis of a malignant tumor is diagnosed by examining sections of the removed formation under a microscope. The sections are placed on glass, stained with a special dye and examined under the magnification of the microscope. These glasses, so-called glass preparations, are stored for many years. If necessary, the patient has the right to request these slides and have them sent to another laboratory for review. The Cancer Center of the American University of Michigan conducted a comparative analysis of initial and revised reports. In the end, in 45% of the cases, the interpretation of the primary opinions was changed. At the same time, in some cases the diagnosis of cancer was dropped altogether, in others the degree of malignancy was changed and, accordingly, the tactics were changed towards more or less aggressive intervention.
Request a report. The result of the consultation with the second/foreign specialist should be a written/printed opinion issued to you on an official form with the doctor's signature and seal.
Follow the logic. If you receive an opinion that contradicts the first, seek a third opinion. Continue to seek an answer to your question until you get a clear answer. After all, it's your body and you are its boss.
A few " Don'ts".
Don't assume that the doctor who provided you with the most satisfying conclusion is right.
Don't assume that Dr. "2" is always right.
Don't be deceived about the greater courtesy of Dr. "1" or Dr. "2". Good manners and affability do not always mean high skill and professionalism.
Remember that modern medicine is a scientific and complex discipline, so there is a possibility of making the wrong decision in the practice of medicine. It is also possible to make the right decision, but it will not be in the best interest of the patient. Getting a second/end opinion will not only give you broad, objective information. A second opinion will give you peace of mind and peace of mind, help you make a sound decision, and give you a chance for a better outcome.