Studies have shown that, overall, about 20 percent of patients seek second medical opinions; in specialties such as oncology, the rate is more than 50 percent. To meet this demand from patients, an increasing number of online services now offer second medical opinions, according to an article in The Wall Street Journal.

Some of these online services are sponsored by established medical centres, including Massachusetts General Hospital and Cleveland Clinic, while others are independent businesses that work with specialists on a consulting basis. Best Doctors Inc., for example, is an independent service that offers second opinions online to companies and insurance carriers that offer them as a benefit.

According to experts, second opinions generally are not needed for easily diagnosed cases, such as sinusitis or shingles. However, second opinions can be important when a diagnosis is unclear, involves a serious or rare condition or when treatment options are risky.

For patients with a serious or life-threatening illness, second opinions might guide them to different treatment options that are less invasive, have fewer side effects or are more targeted to their particular circumstance. “You don’t always know what’s available unless you seek a second opinion,” said Beth Moore, executive vice president of programme strategy for the Patient Advocate Foundation.

Massachusetts General Hospital (MGH) started its online second-opinion service  about eight years ago. The service handled about 10,000 cases last year compared with fewer than 1,000 five years ago, according to Gregory Pauly, chief operating officer of the Massachusetts General Physician Organization at MGH. Second opinions, which cost between $500 and $5,000 depending on the case, are most often requested in areas such as cancer, neurosurgery, cardiology and orthopaedics, Dr. Pauly said.  

Patients can request their medical records be sent to an online second-opinion service, which might order additional tests if needed. The services are especially helpful for people who live far from major academic centres that provide a range of physician specialities. Many insurance policies cover in-person second opinions but don’t pay for online services unless they are offered as part of an employee’s health plan.

In a recent study published in the American Journal of Medicine, researchers reviewed 6,791 second opinions from Best Doctors Inc. Results revealed that there were changes in diagnosis 14.8 percent of the time and changes in treatment 37.4 percent of the time. Also, about 60 percent of the patients ended up following the recommendations from the second opinion. “We don’t know whether the ultimate diagnosis for these patients ended up being the correct one,” said Hardeep Singh, a patient safety researcher at Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, and one of the study's authors.

SecondOpinionExpert Inc., a website based in Dana Point, California, provides second opinions for $300 and the option for a video conference consultation for an additional $200. Some patients can take the process to extremes, said Mark Urman, the company’s vice president of physician relations and quality assurance. “You have to be careful, you can sometimes get too many opinions and all it does is confuse you more and then you don’t know what to do,” said Dr. Urman, who is an attending cardiologist at Cedars-Sinai Heart Institute in Los Angeles.

Source: The Wall Street Journal
Image credit: Flickr.com

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healthmanagement, second medical opinion, academic hospitals, life-threatening illness, cancer, neurosurgery Studies have shown that, overall, about 20 percent of patients seek second medical opinions; in specialties such as oncology, the rate is more than 50 percent. To meet this demand from patients, an increasing number of online services now offer second med