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When in doubt, a Second Opinion could save your life

“In the digital world of electronic health records, easy data upload and video conferencing you can get an expert second opinion with the click of a few buttons. It is no longer necessary to travel long distances to personally consult doctors for an opinion.”
— Dr NK Venkataramana, Chief Neurosurgeon & Founder, Brains Hospital, Bangalore

So, you have been diagnosed with a life-threatening brain disease and cannot believe what you just heard your doctor say. “Why me? This cannot be true,” you tell yourself. But at the bottom of your heart, you sense a rising wave of terror. But wait, before you hit the panic buttons consider this possibility: maybe your doctor got it wrong and you don’t really have cancer after all! Yes, you read that right: mis-diagnosis is more common than you think. This is not because your consultant is incompetent. “In medicine it is possible for two doctors to see the same patient and reports and arrive at different conclusions,” says Dr David Agus, a well-known oncologist who worked at the Memorial Sloan Kettering Cancer Centre and is now with the Mayo Clinic. “This is because diseases don’t often fit into the exact square boxes as defined in text books; at one level medicine is art.”

In a CBS interview that trended for weeks on social media, DrAgus, quotes a study saying that only 12 per cent of patients seeking a second opinion at the Mayo Clinic got confirmation of their original diagnosis, 21 percent received a “distinctly different” one while the remaining 67 per cent got a refined diagnosis. It seems like an ob-vious thing to say but, as Dr Agus puts it, “most people don’t seem to realise that it is hardly possible to treat ef-fectively unless you know what you are up against.” An erroneous diagnosis could cause unnecessary procedures, invasive treatments and even death, say experts. In other words a second opinion is critical: it could give you a second chance at survival. DrJames Naessens, a policy and health services researcher at the Mayo Clinic who led a study on misdiagnoses, says that 10 to 20 per cent of all cases are misdiagnosed, affecting at least 12 million people in The US alone.

According to a 2015 study published in the American Journal of Medicine, a change in treatment plan is recom-mended as much as 30 per cent of the time in The US. Another report points out that around 16 per cent of all se-rious medical cases are incorrectly diagnosed across The UK , Western Europe and The US. “The number of misdiagnosed cases varies across other parts of the world depending on the study or institution but it’s definitely worrisome no matter who you ask,” says this report .

Implication: a huge number of people go through harrowing mental trauma and complex treatments that they probably never needed to in the first place, simply because they hesitated from taking a second opinion. Recollects Dr Agus from his early years as an oncologist at the prestigious Memorial Sloan Kettering Cancer Center: “It was a Saturday call and this young girl came to us from England with a diagnosis of lymphoma (cancer of the lymph nodes). And so we examined her, looked at her under the microscope with pathologists and found that she in fact only had mononucleosis (presence of abnormally high proportion of monocytes in the blood). Now, had she not sought a second opinion this young lady would gone through the trauma of chemotherapy when she didn’t even have cancer.”

Clearly then, if you have been diagnosed with a serious neuro disease and, far from improving, your condition is actually worsening, taking a second opinions the most logical thing to do. Then why are people reluctant? Patients are wary of approaching their doctors for a second opinion reference for the fear of offending them. But that fear may be unfounded in most cases. Says Dr Jonathan Schaffer, an orthopaedic surgeon and Managing Director of the My Consult service at the renowned Cleveland Clinic: “At the end of the day its you and your doctor in this battle, not you against your doctor. In other words partners not adversaries.” Adds Dr Agus: “Most good doctors would say ‘knowledge is better and I want my patient to be really comfortable with what I do.’ Some doctors may be offended but ideally they shouldn’t be.”

With hospitals like Brains, the Bangalore (India)-based neuro-spine tertiary care speciality, enabling patients from anywhere in the world to access leading experts for a second opinion online, getting another set of experienced eyes to review a case has become easier than ever. Says the chief neurosurgeon and founder of Brains, Dr N K Venkataramana: “Regardless of your condition, you can now access us at Brains for a second opinion from the comfort and privacy of your home.” Brains is a super-specialty hospital where trusted experts work with ad-vanced technology to deliver gold standard neuro and spine care 24/7.

Programmes like the Brains Second Opinion give patients and their care-givers easy online access to excellent doctors, helping them take the best possible decisions for illnesses. So, if you have been diagnosed with a serious brain disease, among the smartest things you can and, experts agree “you should do” is take a highly qualified second opinion before starting out on a difficult treatment plan or going through a surgery that you probably don’t even need. It is valuable guidance and peace of mind. Says Dr Venkataramana: “In the digital world of electronic health records, easy data upload and video conferencing you can get an expert second opinion with the click of a few buttons. It is no longer necessary to travel long distances to personally consult doctors for an opinion.”
“Every patient has a right to a second opinion,” says Joseph Fins, chief of medical ethics at New York-Presbyterian and Weill Cornell Medicine, “and it would worry me if a physician was opposed.” Asking for a second opinion doesn’t necessarily mean you’re questioning a doctor’s recommendation. For many, it’s seeking the peace of mind that comes with leaving no stone unturned.” However, be informed that all second opinions are not equal; in other words choosing the ‘right’ source for the opinion is of life and death importance. “It is not like choosing a hair stylist,” says Fins.

Click here to watch the CBS interview of Dr David Agus

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