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There was a time when the doctor's diagnosis and "orders" were taken as absolute. Now people are far more likely to seek a second opinion. A recent medical study suggests that is a good thing.

It only seems commonsensical, but doctors are human, too. Even with the best training, support staff, and equipment, physicians make diagnostic errors. Survey data (mostly gathered by speaking with nurses involved in direct patient care) suggests that the doctor gets it wrong about 5 percent of the time. 

However, getting a second opinion greatly reduces the risk that a patient will get the wrong treatment because of the wrong diagnosis.

Just How Much Difference Does A Second Opinion Make?

A team of investigators affiliated with the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness, and Safety at the Baylor Medical School in Houston, Texas examined two years of data from Best Doctors, Inc. This is a program that allows enrollees, as an option with their employer-provided health insurance, to request second opinions from doctors free of charge. The researchers looked at 6,971 cases in which the insured requested another opinion after getting a medical diagnosis or treatment recommendation.

The most common reason for requesting a second opinion was a question about treatment. This was the primary concern of 41 percent of patients using the second opinion option.

However, it was not unusual for patients to seek a second opinion because they had doubts about the doctor's understanding of their disease. This was the reason 37 percent of patients sought a second opinion. Patients also asked for other medical advice when they weren't happy with the side effects of treatment, or they had questions about whether a different treatment would work better.

It turns out that patients who want a second opinion often have a good reason for wanting it. When the case histories were analyzed by the experts, it was found that 20 percent were incorrectly or incompletely diagnosed. Slightly more than 30 percent of patients who requested second opinions were not receiving the right treatment. Altogether, more than 50 percent of patients asking for a second look received "moderate or major" improvements in care. However, nearly two out of three patients reported they just want to make sure they were getting the right care.

The message here seems to be that if you think your doctor doesn't quite understand your case, you are probably right. It pays to get a second opinion.

Will The Results Of This Study Result In Humbler, More Thoughtful Diagnoses?

While there is now good evidence that getting a second opinion makes a real and positive difference in patient care, that doesn't mean that the medical profession as a whole is particularly enthusiastic about making second opinions available to most of their patients. In the words of the researchers conducting this study, "Further evaluation is needed to determine whether this impacts clinical outcomes, such as the reduction of diagnosis and treatment errors."

As a practical matter, doctors often loathe hearing their patients quoting Dr Oz or bringing in information on natural medicine from heavily advertised sites on the internet, and not without reason. There's a lot of bad information out there. It takes serious and sincere effort to provide accurate medical information online, and nothing substitutes for being physically seen by a doctor who has clinical experience. However, that doesn't mean you are necessarily stuck with your doctor's opinion.

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