Second opinion at a distance

There is an interesting piece of new in todays USA today about taking second opinion for health conditions online from experts. You send your medical records with or without your primary doctor’s help via internet to Experts( places providing paid service) and get their opinion after a week or so.

Online second-opinion services offer patients consultations from specialists based on the medical records that they fax, mail or send via the Internet. The average cost, payable upfront via credit card, is $500 to $1,500, depending on the number of radiology or pathology interpretations required. Patients then receive online access to a second opinion in about two weeks.

What I find very interesting is the amount of changes in treatment or diagnosis as per this article.

More choices, ‘more peace of mind’

Not all remote second-opinion services require that a patient’s local physician participate. The Cleveland Clinic, for example, delivers consultations directly to a patient, while POSC shares them with the physician first and then with the patient.

In Harlow’s case, her physician “welcomed” the idea of a second opinion. Harlow says she opted for the whole-breast radiation treatment, based on the report from Lawrence Schulman, a leading oncologist at Dana-Farber Cancer Institute,

“In about 5% of the cases, we actually change the diagnosis of the patient. In 85% to 90% of the cases, we alter the treatment,” says Jonathan Shaffer, managing director of e-Cleveland Clinic. “What we are able to do is give the patient more treatment options and hopefully give the patient more peace of mind,” he says.

Shaffer says people are beginning to realize the convenience of e-health technologies. “It continues to grow every year.”

Considering the rapid progress in internet technology and telemedicine these are bound to increase. Radiology is quite in the forefront. But is it viable in the long run?

Quite a majority of cases are such where the diagnosis and the treatment is not in doubt and the physician is quite comfortable in following through the treatment. It may happen that the patient remains unsatisfied and may want a second opinion or alternative treatment. And why not? after all it is his money and body. He might remain dissatisfied with the second opinion as well.

Physicians have been taking second opinion unofficially and consultations officially whenever they are unsure about management of a particular disease or presentation; but will they follow up on perceived unsolicited advise?

Do not expect the primary physician to follow and carry out the advice given by the Case manager /Second opinion provider unless he himself (or herself) co-initiated the consult. It is quite apparent that the second opinion will also be a medical consultation with its attendant liability and responsibility unless waived off by the patient( and then that has its own consequences).

The need for second opinion arises more in evolving fields like Oncology or where there are multiple treatment options under evaluation. For example- If the patient remained unconvinced by the doctor providing second opinion then what? back to square one..Patients need to have faith in their doctors and the doctors need to have knowledge to get that trust.

Whatever shape it takes in future; there is money to be made and does fill in a perceived need so will catch on.

Read the complete article from USA Today.

Pic from