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.
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.
After my regular PC DR refused my WC case, I had “MY” neurologisat/orthopedist’s nurse(who treats me for degen arthritis) tell me that without a workman’s comp number they wouldn’t see me in waterbury ct, despite being chosen as the designated initial care in the injury, because they are a “business”.. so I had to go to a chop shop who gave me pills and sent me back to work with an obvious neurological issue..and a referral to that very same Dr…NOW WC is sitting on the case and I am stuck waiting for approval bc the “nurse” admittedly didn’t know how to process initial care forms. of course Workman’s comp doesn’t “hurry” anything, because individual employees aren’t held responsible for their inaction.
trouble is, what makes the second opinion always correct? What if the second Dr. is wrong and instead of getting treatment you are told you are OK and you are not.
But … but … I thought doctors were gods.
Well if the “scientific” diagnosis process was so sound why this number?
When will one be able to sit in a chair and have blood, saliva, urine, sweat, hair, breath, heart rhythm & etc analyzed by a Dr. Watson supercomputer with follow up CT scan or etc? That would seem to be enormously thorough and efficient. The machine could make referrals of course.
If Doc Nr 2 confirmed what Nr 1 had said, the patient might return to Nr 1 next time – since he/she had it “corect.”
And just like car mechanics, whether they fix the problem or not, you have to pay!
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.
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.
Doubts about the first would be the reason why one seeks a second opinion.
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 !!!!!
Maybe people who seek a second medical opinion have a reason to suspect the accuracy of the first…
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!
50% of all doctors graduated in the bottom half of their class. 😉
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.
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” !!!
You forgot to tell us what the solution to your issue was.
Medical Marijuana !