Second opinion from doctor nets different diagnosis 88% of time, study finds

ROCHESTER, Minn. — When it comes to treating a serious illness, two brains are better than one. A new study finds that nearly 9 in 10 people who go for a second opinion after seeing a doctor are likely to leave with a refined or new diagnosis from what they were first told. 

Researchers at the Mayo Clinic examined 286 patient records of individuals who had decided to consult a second opinion, hoping to determine whether being referred to a second specialist impacted one’s likelihood of receiving an accurate diagnosis.

The study, conducted using records of patients referred to the Mayo Clinic’s General Internal Medicine Division over a two-year period, ultimately found that when consulting a second opinion, the physician only confirmed the original diagnosis 12 percent of the time.

Doctor
A new study finds that 88% of people who go for a second opinion after seeing a doctor wind up receiving a refined or new diagnosis.

Among those with updated diagnoses, 66% received a refined or redefined diagnosis, while 21% were diagnosed with something completely different than what their first physician concluded.

“Effective and efficient treatment depends on the right diagnosis,” says lead researcher Dr. James Naessens in a Mayo news release. “Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling ─ not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”

Considering how health insurance companies often limit the ability of patients to visit multiple specialists, this figure could be seen as troubling.

Combine this with the fact that primary care physicians are often overly-confident in their diagnoses, not to mention how a high number of patients feel amiss about questioning their diagnoses, a massive issue is revealed.

“Referrals to advanced specialty care for undifferentiated problems are an essential component of patient care,” says Naessens. “Without adequate resources to handle undifferentiated diagnoses, a potential unintended consequence is misdiagnosis, resulting in treatment delays and complications, and leading to more costly treatments.”

The researchers acknowledged that receiving a completely different diagnosis could result in a patient facing otherwise unexpected expenditures, “but the alternative could be deadly.”

According to the release, The National Academy of Medicine cites diagnostic error as an important component in determining the quality of health care in its new publication, Improving Diagnosis in Health Care:

Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in health care. Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity.

The study was published in the Journal of Evaluation in Clinical Practice.

Comments

  1. I went to the doctor when i was healthy and he told me I was sick. I asked a doctor how many patients he has cured and he told me we don’t do that. Think about it no diseases cured ever. They create a disease and manage it according to your insurance. I decided to only go to the doctors if I was really sick and it has been ten years now. I don’t even know who my primary care physician is.

  2. Imagine if a civil engineer designed a building or a bridge, and 88% of the time a second civil engineer would look at his design and say it was wrong. That engineer would be fired. Yet with doctors, it’s perfectly fine. Oh,yeah, and let’s pay them a half million a year while we’re at it.

  3. The study is flawed because they failed to include the underlying broken system that we call medicine . Both physicians and patients have been far more damaged by the system which has replaced basic medical ethics and physician autonomy with a fear based environment. “First do no harm” has been replaced with first do harm to your career. whether a physician works for corporate medicine or in private practice they must “go along to get along” and whistle blower protection for physicians who advocate for physician does not exist. In other words good ethical caring physician routinely put the needs of patients first but will inevitably burn out or be driven out by greed from insurance companies, their employers who want them to see 4-5 patients per hour or by the licensing boards (government).
    I am amazed at the lack of understanding or indifference to the truth about our current medical system . Money runs medicine and patients will rarely, if ever, find good care unless they are rich or lucky, Patients with excellent insurance will get 5 opinions and diagnosis’s if their insurance allows but in the end are nothing more then a cog in the wheel of medical extortion. Consider this fact drug companies run Washington and we do not allow alternative medicine as a acceptable approach to medical care and then you will understand why the cure for cancer has been around for better than 30 years. Follow the money !!!!!

  4. So true. About 8 years ago, I was having horrid neck and arm pain. After MRI, x-rays, etc a reputable orthopedist told me I needed immediate surgery. Went to another ortho doc who referred me to a pain orthopedic specialist. Lots of physical therapy, exercise, home traction and prayer/meditation. 8 years later, my neck problems are under control and I never had any invasive surgery. Always get that second opinion!

  5. What’s missing here is which diagnosis was correct, the first or second, or even neither. A second opinion is important only if A) the first was wrong and B) the second was correct, but we have nothing indicating that was the case. And if 80% of the time one of two diagnoses was wrong the odds are great that at least some of the time both were wrong.

  6. I stopped trusting doctors, when my Neurologist from Scripps said there was nothing more they could do for my non-diabetic Peripheral Neuropathy in my feet. This ailment has kept me from walking more than a mile before having to stop, or I’d be on pain medication which would eventually destroy my kidneys and liver.

    There is a definite reason they call it: “PRACTICING MEDICINE”. The figure they don’t want you see, is how many people are killed each year by either missed diagnosis, wrong prescription, corrected prescription given to the wrong person etc.

    http://www.naturodoc.com/library/public_health/doctors_cause_death.htm

    “The U.S. health care system may contribute to poor
    health or death. According to Dr. Barbara Starfield of the
    Johns Hopkins School of Hygiene and Public Health, 250,000 deaths
    per year are caused by medical errors, making this the third-largest
    cause of death in the U.S., following heart disease and cancer.”

    NOW TELL ME THEY AREN’T “PRACTICING MEDICINE” !!!

  7. Yeah,I was listening to the radio and had on the Peoples Pharmacy.The guy went to his doctor friend for blood work.He told his doctor friend do me a favor, my son requested that you take another blood sample and send it out to another lab.The doctor did,and when the results came back he was amazed,and he thought is was from two different people.The blood work results were way different when compared.!!!!! Now what does that tell you.!!!
    Remember when the doctors go on strike,the death rate goes way down..!!

  8. According to the numbers presented only 12% of these second opinions actually produced a “different” diagnosis. The rest appear to have refined or confirmed the original diagnosis. Research confirms that research can confirm whatever it sets out to confirm and that headlines can be written accordingly.

  9. Eventually, human diagnoses will be replaced with AI diagnoses. When that happens, there will be much less chance of differences between first and second opinions. However, whether the results will be better than what we have currently is anybody’s guess, since AI is only as good as its programming allows it to be.

  10. My wife has a “gi” problem and we have gone to 4 GI Dr. and they can not figure it out. We have had a consult to Mayo for 3 years, TRY TO GET IN, JUST TRY. GOOD LUCK!!

  11. why the [and] here?
    ” may be completely [and] incorrectly diagnosed ”

    ‘completely incorrectly’ seems fine on its own. otherwise aren’t you implying ‘completely diagnosed’? that seems wrong.

  12. Fully agree. Get a 2nd opinion on a general principle especially on major health issues, infections, surgeries, etc. Amazing what the prognosis is from 2 Doctors on the same problem.
    Also
    do some of your own research before seeing the Doctor so you are familiar with the problem and can ask questions.

  13. Medicine, the term they like to use which is correct that this Study left out is all MD’s are “Practicing Medicine”.

    They use a book of Symptoms to tell them what Drug you need. Now if they are having a difficult time they will place a call to other Dr’s to discuss your issue.

    All the while your setting waiting for the Dr to return and most of the time with the wrong Prescription he has for you.

    A good rule of thumb is, when you tell them your Symptoms and their eyes glaze over it’s a very good sign to get up and leave, find another Dr…

    Remember Dr’s are “Practicing Medicine” They are not experts..!!!

  14. “That is a second opinion. I changed my mind.” “I don’t know what you have, which is why I am prescribing a ‘Cure-All'”.

  15. It seems rather obvious that there are at least two (and likely more) reasons for seeking a “second opinion”, and those differing reasons are why the 88% change in diagnosis is TOTALLY, AND COMPLETELY, INSIGNIFICANT.

    1. The patient’s ailment isn’t responding to treatment.
    2. Not all specialists are equally skilled.

  16. The Lubavitcher Rebbe advised people for years to ask two doctors and that one of them should be a friend.

  17. U no when ovamitcare kicked n our old timey docs retired and the mussy & indian docs moved n- a lady i no jobs is HR- job is to verify docs r docs- now keep n mind they hav to work n small town 4 two yrs b4 applying to a big hosp- 40% of those docs R NOT DOCS! They been practicing n a small town for two yrs- how many old people hav they killed or small children etc? I think this is a REAL SCAREY STATISTIC!

    Then look how many people r diagnosed w/cancer! Do they really hav cancer? Lots of money in treatg cancer – lots of money in the meds too! In essence u r told u hav cancer by a foreign doctor who then gives u chemo which kills good & bad cells n ur body- beginning to think the foreign docs r killing us on purpose! Had to compile a list of my sisters docs involved w/her cancer – they all had the same mailing address which i found to b weird! They say: let me get w/my team- their teams consist of other mussy/indian docs- JUST SAYN: TOO WEIRD!!!Something Americans really need to START THINKING ABOUT!

  18. I’m surprised this eighty-eight percent figure for misdiagnoses isn’t even higher. The type of diseases we are diagnosed with depends on what kind of equipment a particular doctor owns.

    When the Wall Street Journal replaces the medical journals, we shouldn’t be surprised at what happens.

  19. Literaly everytime i go to a specialist my diagnosis is always different. My diagnosis always seems to change based on the speciality of the doctor. As an example, I wanted to prove that doctors were BS. So i decided to go to an “Ear Nose and Throat” doctor. Without having any throat problems i anticipated that he would say i have Gastrointestinal Reflux. Thats exactly what happened! He wrote me a script for Omeprazol. What a joke.

  20. Some of these doctors , just because they went to school , doesn’t mean they know what there doing .

  21. For almost any set of symptoms there are numerous health problems that fit the bill. Finding precisely what is wrong often requires time. A doctor may say “I think it is probably this, and if it is what I think, then this will help you, if it’s not, then come back and we’ll do more intensive tests”. The patient may not like this, so they go to another doctor. After conversing with the patient, the second doctor realizes that the patient will not accept the same diagnosis as the last doctor, and so the second doctor proposes another possible health problem that could match their symptoms.

    In that case, it’s not so much of a disagreement between doctors as it is the patient steering the second doctor in a different direction from the first.

  22. I do not know about 88%, but as an attorney I must say that many many times the second opinion from an attorney can be quite different from the first.
    And look at appellate judges’ opinions in a case. It is fascinating how nine judges who heard the very same case can arrive at such differing ways of looking at the application of the law.

  23. The different opinion of the doctors is not the only thing I noticed. They also do not use the same exact test equipment or machines, and those things can give different results that lead to different opinions and remedies.

  24. BLOOD PRESSURE. I went to one hospital and that doctor used a stethoscope and watch and he says 133. A private clinic doctor used a wrist wrap and it said 98. A different city hospital and doctor who used the arm wrap and it said 113. I went to a WalMart and their machine said 116. All of these readings in a 6 day period. Screw them. I trust WalMart.

  25. A chest X-Ray showed a spot on my lung. A PET scan showed it was metabolically active. A surgical biopsy showed it was cancer. The pathologist diagnosed as an extremely rare lung cancer that my surgeon said was 95% likely to have been cured by surgery. Good news. It did not occur to me to seek a second opinion. Two years later, follow up chest X-rays showed new spots on other lung. Doc said it could not be same cancer as it does not behave that way. New biopsy at different hospital gave different diagnosis. Re-checked first tumor and said it was same kind as new ones. So instead of stage I rare lung cancer I had stage IV melanoma. Treatment delayed by two years. Unknown how this will turn out. So sometimes even when you hear good news you should get a second opinion. Maybe with pathology that is always the case.

    1. Hi D, I read one of your comments about cancer treatments on another website and I was wondering if I could ask you a few questions in private (by email, if that’s okay with you).

      1. Hi Lilly. Sorry for the delay. You can find me on Facebook with same username and you can pm me there I believe.

  26. Unlike all my “Natural” and Vegan friends- Doctors are an essential part of your health care team. But they almost always have a “God complex” and are very offended if you mention you read something on the internet or want to see another doctor. In the past, my PCP said I had Emphysema and would be dead in a year. I went to a different doctor and he said my lungs were fine. 5 years later- and I am still alive and no Emphysema. I just had allergies. Another PCP said my heart was as healthy as a 18yo. I had chest pain so I refused to believe him and went to another doctor and he found out I had 2 arteries blocked to my heart. Haha. Almost every doctor’s office now has multiple copies of the WebMD magazine in their waiting room- but God forbid you ever mention you read something on WebMD! Haha. When I mentioned I read something on the Mayo Clinic’s website my PCP said “Don’t listen to them! I know what I am talking about!”.

  27. Interesting but this should be an indicator of what further study should be done. It should not be considered definitive. Notice that these were patients who, either on their own or at the first doc’s suggestion, went for a second opinion. It was a select sample, not a study of all diagnoses. The study says nothing about those who were satisfied with the first diagnosis.

    A definitive study would send random patients for a second opinion, whether those patients or their doctors had requested it or not. That would give a better idea of how often the first diagnosis is corretc.

  28. In other news, a new study confirms that studies that study studies are far more likely to have been the study of a study of a study.

  29. And health care cost continues to rise. We don’t accept this kind service from car dealers. Our Daughter recently spent three days in the hospital and no diagnosis. Mom told her symptoms sounded like thyroid. Her doctor confirmed. No wonder most people have lost faith in health care.

  30. This is pure BS. If this is what we pay the highest healthcare costs in the freaking world for. Our medical system has been hijacked by thieves masquerading as doctors.

    1. This proves without a doubt that American healthcare RIPS YOU OFF. 90 PERCENT !
      How can they say they are not stealing !

        1. Either the first opinion or the second in 90 percent of the cases was wrong. But the dumbass gets paid regardless.
          Our healthcare system is a f,ing joke.

  31. We have a bloated, overpriced healthcare system that is bringing us all to our collective knees. Just like the bloated, overpriced, easy federal loan, higher learning racket.

  32. If our doctors were perfect it would be 0 difference. Obviously that would be unrealistic. BUT 88 % is criminal.

  33. I remember several years ago, a woman named Hillary, whose husband was the President, ushered in a thing called “Managed Care”, that put the “cheaper primary care doctor” in charge of your health care, and the “cheaper primary care doctor” was financially penalized for referrals to a specialist.
    If your insurance plan includes a “panel” of doctors, requires a “preauthorization” by the insurance company for tests or procedures, or requires that tests or procedures be done at a place of their choosing, then you are experiencing a remnant of this.
    One thing strikes me as a bit odd about this study. The doctors at Mayo are assuming that they are correct about the new diagnosis, and the prior doctor is incorrect. The opposite may be true, as there is no mention of any confirmatory method of the new diagnosis.

    1. Medical just denied an MRI for my injured hip and I haven’t been able to walk for over 2 months now. Back to my PCP to let them know. Much suffering ahead. 🙁

  34. It really sounds like the Mayo Clinic is trying to drum up some business for itself. Things must be slow.

  35. I have had six wrong diagnosis’ in six years. One from a local ER doctor and five from VA doctors. One doctor, after a few mins of talking and no exam, said my gall bladder had to come out! Turned out to be an HPelori infection removed with antibiotic treatment.

    Since the medical “practice” is the number three cause of American deaths (wrong or mis diagnosis, wrong meds, etc.) one should certainly be cautious on any duagnosis that requires meds or invasive treatment.

    1. I had the exact opposite just happen. First ER doctor said it was constipation and sent me home. They took my highly inflamed and infected gall bladder out two days later.

  36. “A new study finds that nearly 9 in 10 people who go for a second opinion after seeing a doctor are likely to leave with a refined or new diagnosis from what they were first told.” The assumption is that the 2nd opinion is the correct diagnosis. I would like to see the data that confirms that assumption.

  37. It’s happened to me over a suspected cancer seen on ultrasound. In fact two doctors in the same specialty practice, literally standing shoulder to shoulder looking at the same scans had differing opinions. It turned out to be negative, thank God.

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