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. It’s so common to misdiagnose low back pain that a cpt code was developed called “failed low back surgery syndrome.” The surgeries are often done formthemwrong reason. Go conservative. See a chiropractor first

  2. INTERESTINGLY, THE COST OF CARE CONTINUES TO ESCALATE AS QUALITY DETERIORATES. THE AMERICAN MEDICAL SYSTEM IS PURELY FEE DRIVEN WITH NO ACCOUNTABILITY.

  3. i don’t find that unusual or undesirable……modern medicine is the most complex and nuanced discipline in the world….mastery of even a tiny fraction of it is a gargantuan superhuman task….so differences of opinion and interpretation are the rule, not the exception, in difficult or obscure cases, which are legion.

  4. Latrogenesis, physician induced illness, is the third leading cause of death. The time of my Doctor knows best, has long passed.

  5. So you THINK that the Russian election hack is off the publics’ radar??? Well tomorrow, 4/9/17 it will be FRONT PAGE NEWS! The New York Times is set to release a BLOCKBUSTER story tomorrow – THE NAMES OF THE TWO RUSSIAN AGENTS BEHIND THE DONALD TRUMP ELECTION HACK!!! The NYT claims to have HOURS upon HOURS of what it calls “extremely reliable surveillance footage” showing two here-to-fore nameless Russian operators: Boris Badenov and Natasha Fatale. It shows the duo working their clandestine operation code named “Moose and Squirrel” that spanned a range from the halls of power in our nations capital to rural Minnesota – all coordinated by a power broker called “Mr Big” and an as-of-yet-to-be identified double agent known only as “Mr. Peabody” and his “trigger man”, Sherman!! It is said that even the Royal Canadian Mounted Police are involved! Just the kind of journalism that you’ve come to expect from the New York Times!

    1. Beautiful Jellystone National Park photos coupled with the article; wonderful place. I don’t understand how Boris and Natasha keep ending up there. Even if they wrecked the whole park, who’d really care?

    2. “Just the kind of journalism that you’ve come to expect from the New York Times!”

      ………………………………….. “ALL the news that’s _ _ _ _ to print.”
      …………………………………………………….(NYT)
      —————————————————————
      Regards.

  6. If I need a limb reattached or a severe wound sewn up, I’ll see a doctor. For everything else, I’ll deal with it on my own.

  7. This study looked at referrals from a primary care physician (PCP) to specialists (not patient’s seeking a random second opinion). Referrals are made when the PCP — advocating for the patient — is seeking a higher level of care from a specialist. This is generally a good thing, even if it leads to a new diagnosis (after all, the intent of the referral is to help the patient). The study demonstrates that a majority (79%) of patients referred to a specialist had the same or refined diagnosis. For example, if a patient complained of chest pain, and a primary care physician’s EKG or stress test was concerning, an appropriate referral to a cardiologist might reveal a refined diagnosis such as narrowing in a certain coronary artery. Who would consider this a failure on the part of the referring physician?

    This article’s insinuations are causing lay readers to draw incorrect conclusions. Sadly, it will likely gain more traction as popularized on sites like Facebook and the DrudgeReport.

    1. I’ve had times when we concur abt specialists, and times when I KNEW he was dead on wrong, and that it would take me extra suffering or a second to get the RIGHT call.

      1. Lincoln didn’t have the Internet. It can be used intelligently, not just the way “doctors see patients” ie, Googling their headache and thinking they have brain cancer, etc. There is good info to be found on the www. IMPORTANT. You always need to consider the source. Peer reviewed, double blind studies done by teaching hospitals vs. some Joe Blows blog for example. I could go on and on….but I will spare you. You get the idea. Good day.

      2. It was actually Brian Williams who said that as he was getting shot covering a skirmish in Iraq.

    1. I suddenly couldn’t hear much out of my right ear.. It was Friday night, so I decided to call my doctor for a Monday appointment. Then I got worried. Never heard of anything like this before.. So, I used google, and got a surprise! Within a half hour, I was in an ER. Nurse called a sleepy specialist, a good one. I got meds (corticosteroids) within the hour. Saved the hearing in my right hear..
      Very rare disease. They want me to donate my head to medical science.
      It’s so rare, that one ear-nose-throat specialist got it, and decided to wait until Monday.. He lost all hearing in one ear.. I guess he didn’t have Doctor Google..

      https://www.nidcd.nih.gov/health/sudden-deafness

  8. Of course they keep mocking EMF exposure just like when the profession mocked disinfecting hands between surgeries and smoking.

  9. Both my parents passed away a couple years ago, and I think that the doctors got it wrong on several accounts. My dad had pneumonia and a doctor gave him some medication that made his kidneys worse, and basically told me “Ya, I knew it would increase his creatinine levels.” Man, that was the one thing we were really monitoring and trying to get down. He died within the next day or so. For my mom, it took almost four months for someone to finally tell us that she had had several mini strokes. There were at least three or four doctors who saw her that should easily have known what it was and they either just rushed to judgment as she was “old” or scheduled this or that to pass the buck. Sad.

  10. Is there any information on how often the original diagnosis turns out to have been the correct one and the dissenting second diagnosis in error? Just because you get a second opinion doesn’t mean that second opinion is the right one.

    1. Get a 3rd opinion. Also, unless time is of the essence, try the cures that are cheapest and least risky first. I acquired a digestive problem in Costa Rica resulting in a swollen belly and what felt like WWIII if I drank any alcohol. I had about 6 tests done in the USA including a fecal exam. I was told that I did not have a problem, but stay away from alcohol and lose weight. Six months later I was in Colombia where I saw a pharmacist who told me I had a parasite since so much time had passed with no change in symptoms. He gave me 3 large pills for large parasites and 5 small pills for small parasites (pharmacists, a Doctor of Pharmacology, can prescribe medicine for free in most countries outside the USA or refer you to a doctor for tests). So, I took the pills as instructed and waited 10 more days before consuming any alcohol. The problem was solved at a cost of about $4 after spending thousands in the USA for tests. I think that doctors are inclined to reach a diagnosis for problems with which they are familiar.

    2. You don’t, but it is a red flag to you that more input is required. If you have differing diagnosis the insurance company cannot deny further opinions from multiple sources.

  11. Only if you are lucky enough to go to a doctor outside of the Original Doctor’s Group or Hospital. The Mayo and Cleveland Clinic are the best. Locals not so much!

  12. Many doctors are unable to look at an MRI or CAT scan and decide for themselves if anything is amiss. Some healthcare facility technicians send all scans out to a third party to be summarized into a report. Your doctor may then simply paraphrase the report to you as if it is his own diagnosis. When you take your scan and it’s report to a second doctor for a second opinion, make sure he does not also simply paraphrase the report to you. Some doctors are unable to form an opinion other than what is in that report. Every scan, from broken ankles to brain tumors, created by your local hospital may in fact be diagnosed by a single doctor located in India. The internet allows for that nearly instantaneous transfer of information.

  13. In the last ten years it seems doctors have gotten incredibly greedy with their time and more aggressive grabbing money. Doctors now want you to see their PA first so they can bill you twice & give 2 wrong diagnosis. Good “bedside manner” is nonexistent and they don’t want to answer many questions….probably because they have no clue or answer.


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