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Second Opinions

Posted 9/14/2015

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  Here is my rule of thumb about second opinions: If you are wondering if you should get one, do so. What you absolutely want to avoid is a moment in the future when you wish that you had seen another doctor for another opinion. We are blessed in Boston to have several world-class hospitals and doctors. It is rarely necessary, if you live in or near Boston, to travel for another opinion, but I do know some people who have opted to do so. Occasionally someone with a rare cancer will identify a super expert somewhere else, and it seems worth the trip to meet with her. And sometimes there is a worry that doctors in the same city, let alone in the same institution, will automatically back one another up or have the same views. I think that is not necessarily true.

  In Cancer World, what are the most likely times to consider a second opinion? Here is a short list:

1. At the time of diagnosis although many cancers (e.g. most early stage breast cancers) are very straight-forward, and all trained oncologists will make the same recommendations.In this situation, however, there may be questions about the need for chemotherapy (e.g. if an Oncotype score is in the medium range) or mastectomy vs. wide excision/radiation therapy.

2. If the cancer recurs and at future moments of progression. This is when oncology becomes the art of medicine rather than strictly the science of medicine, and different doctors may indeed have different approaches.

3. If you are considering enrollment in a clinical trial.

  And here is a really interesting article from the Wall Street Journal about new online ways to get second opinions. 

New Ways for Patients to Get a Second Opinion

By
SUMATHI REDDY

For many patients, it has become a routine part of the medical
process: Get a diagnosis or treatment plan and then seek a second
opinion.
A growing number of online services are offering second opinions and
some are seeing increasing patient demand for a second set of eyes.
Some of the services are sponsored by established medical centers,
including Massachusetts General Hospital and Cleveland Clinic.
Others are independent businesses that work with specialists on a
consulting basis. Employers increasingly are contracting with such
services, and insurance companies at times require patients to get a
second opinion, such as for surgery.
Studies show as much as 20% of patients seek second medical
opinions; in specialties such as oncology, the rate is more than 50%.
And recent research has found that second opinions often result in
different diagnoses or treatments.

Read more: http://www.wsj.com/articles/new-ways-to-get-a-second-opinion-1440437584?tesla=y

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