It’s not so uncommon to want or need a second opinion – especially if there’s doubt about what’s wrong with you or you are being told you need some particularly invasive surgery or poisonous chemo therapy for example.
The problem is finding the right person; getting an appointment; physically getting yourself there – all before you die.
Well, a relatively new development can help out. On line second opinion.
This service has grown out of the whole telemedicine industry, and specialist centers providing advice to international patients. As with any telemedicine service, you usually consult the doctor face-to-face by video link – but if you live in the boonies, this can be a real boon.
It’s better than phone consultation in that the consultant can see you – your expression/reaction as you consult. Or can see any pathology that is visible (rash, mole, swelling deformity, etc). They cannot listen to your heart and lungs (though there are more and more services that will record and transmit basic vital functions like blood pressure and heart rhythm). Nor can a consultant palpate your various parts – though qe have remote control surgery already, how long will it be till there’s some kind of computerized arm that can poke and prod you?
One of the main advantages is, if you have some very obscure, or arcane problem, telemedicine consulting allows you to confer with the most expert specialist regardless of where they are in the country – or in the world providing there’s internet access.
Tracking Down That Specialist
As with any second opinion, you need to find the relevant specialist, and this can be challenging.
Normally your doctor is the best person to refer you, as he or she knows you and your condition and, hopefully, knows which specialist is the best and what kind you need (it’s a bit of a Catch-22 sometimes, in that you almost need a specialist to tell you which specialist to go to).
However, if you are looking for a second opinion because you are unhappy with your doctor, are seeking a “hostile” second opinion, this can be awkward, and you might not want to ask your doctor.
Or people just feel uncomfortable asking their doctor for a second opinion as they feel the doctor will see it as a vote of no confidence. But it’s desirable that your doctor should know as you are liable to need records from him or her; whatever treatment plan the second opinion doctor comes up with is liable to involve him or her; and some consulting services actually require you to get our doctors permission, and will only send their report to your doctor – which seems to me the ultimate in paternalistic medicine.
Hopefully the opposite is true and your doctor will be happy to share the responsibility of figuring out what’s wrong with you or what’s the best management.
Usual advice when looking for a doctor is ask your friends, or family, or nurses at the local hospital. But this is a bit different – and the doctor’s characteristics like bedside manner, age, sex, political/religious/philosophical bent, and how the office runs isn’t nearly as important as for your primary care doctor.
If you just Google whatever illness you have, this will often lead you to a relevant specialist. Or go to the national organization if you have some clearly diagnosed illness, like Parkinsons Disease, rheumatoid arthritis, diabetes.
Healthline, at https://www.healthline.com/health/second-opinion-telemedicine-companies#1 lists several companies that will provide an online second opinion.
Grand Rounds – started by Lawrence "Rusty" Hofmann, professor of interventional radiology at Stanford University School of Medicine, after his son, Grady developed aplastic anemia and he donated bone marrow. Being a doctor himself, and at a tertiary care hospital, Rusty Hoffman had fairly good access to specialists – and was able to get Grady the best treatment.
But he realized other people with critical problems needed to be able to find the relevant specialists. So he set up a network of, what the organization claims are world class physicians, to provide consultations.
Many of the on-line second opinion sites are affiliated with large medical centers, like The Cleveland Clinic and the University of California at San Francisco, or the Dana-Farber cancer institute for example, so a tertiary care center like one of these specializing in your problem should work.
Like any doctor you consult, the specialist is going to need all your information. Especially tests and imaging results. But also notes from other doctors you’ve seen, to know what they think and what has been tried.
You usually get this from your doctor – but sad to say, not infrequently your doctor doesn’t have all the information. So it is up to you to scour around all the establishments and doctors you have seen to get this. Some of these companies and health centers will help you with that.
It may be that your insurance will not pay for an on-line second opinion, so maybe check before you commit to some big bill.
Lastly, if you go for a second opinion and it is completely disagrees with what you are being advised by the first doctor - you may just end up needing a third opinion.