Second opinion is a tool for ratification or modification of a suggested treatment by another physician. The need for second opinion can be explained by an example – A female patient was diagnosed with unstable angina.
Cardiac Angiography showed LMCA (Left Main Coronary Artery) Stenosis. The patient was provided with the option of undergoing a cardiac bypass surgery (CABG). Immediately the family got worried why CABG?
Since their neighbour, Mr. Singh underwent stenting in 5 vessels whereas in this case there was only one vessel involved and yet the doctor recommended CABG? Why? In a complex and sensitive situation like this, a second opinion can prevent mortality and morbidity.
When Rx protocol is challenging and confusing
The lady has been diagnosed with LMCA involvement for which the CABG is class 1 indication as a treatment option. Seeking a second opinion can help to take informed decision and avoid confusion. If she undergoes stenting in LMCA her next attack would be fatal due to stent thrombosis.
Certain cardiac diseases can showcase dizziness, syncopal attacks like arrhythmia. Misinterpreting this the patients continues to show to a neurologist, endangering his life as arrhythmias are serious and patients can immediately go into cardiac arrest
Rarity of the disease
ARVD (Arrthymogenic right ventricular dysplasia) is a familial disease where cardiac tissues get replaced by fat and fibrous tissues, can occur mostly in young people resulting into sudden death especially…athletes
When doctor patient communication is poor
Diagnosis of serious cardiac ailments like MI (myocardial infraction), heart failures, congenital heart diseases etc. could drain you both mentally and financially. Having proper communications lay the very foundation of trust and effective management of the disease. Rising Corporate interest in healthcare has made this process expensive and frustrating.
Right to second opinion
The Ministry of Health & family welfare, GOI, has published a charter of 17 Rights of Patient. The 6th Right among these is the Right to Second opinion. So IF you are not convinced by the diagnosis or treatment or just want a reassurance, do not ever feel awkward or threatened about what your primary doctor will think. Remember it is your body and the decision should be yours alone
When your doctor recommends a second opinion: There is much awareness of second. And patients do exercise this. Various institutions like the Stanford University, Cleveland Clinic, ForeignOPD.com etc… have come a long way in creating the right atmosphere and changing the mind-set of patients and doctors about the importance of second opinion. Insurance companies in USA & UK are reimbursing the cost to patients for seeking second opinion particularly when surgical intervention is involved which saves money both for patient and the healthcare institution
Finding out that you have a heart condition is always scary. Medical treatments recommended could get confusing and that is not at all a good state to be in. A second opinion can help ease your mind by confirming that you have been diagnosed correctly and effectively.
Many patients who have had sought second opinions in in their heart care have learnt that treatment is possible even if other doctors have given up. Expert opinions based on latest research and technology can allay the fears of patients & their families and making heart care nothing to be apprehensive or fearful of.
The author is an MD- Emergency Medicine, ECFMG Cert. USA, Ex Senior Resident SGPGIMS Lucknow