7 Tips when getting a Second Medical Opinion

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7 Tips When Getting a Second Medical Opinion

Dear Readers,

If you're received a serious medical diagnosis, you should

consider seeing another physician for a second opinion. Not because you

shouldn't trust your first doctor, but because you need to become as informed

on your illness as possible and different points of view can help you in

considering your options for treatment.

The following are seven considerations you should always keep in

mind when getting a second medical opinion:

1. Is there agreement?

The obvious and key question to begin with is " Does the 2nd

doctor agree with the 1st diagnosis and the implications of it? " If not,

you should consider getting yet a 3rd opinion and even a consultation at a

University hospital or academic center.

2. What are the 2-3 best treatment options?

What are the 2-3 best treatment options and what are the

benefits, risks, and cost of each? Unfortunately, medicine as a business and

economic factors often cloud a practitioner's judgment. This is not because

they mean to intentionally misguide you, but there are financial incentives

involved and you need try to understand their potential influence on the

doctors.

In medicine, this is a problem in a couple of ways:

Virtually all of most

physicians' ongoing medical education is paid for by the drug companies

and represents slick advertising masquerading as educational activities.

This even includes most of the studies in well-known journals. These

studies are paid for by the drug companies and the journals' main source

of income is often drug company advertising, an obvious potential conflict

of interest. Research shows that a study paid for by a drug company is

often not reliable (as much as 40-2,000% more likely to show a positive

result than an independently funded study!). Most doctors think that they

are being responsible and scientific when in actuality they are pushing

expensive and often toxic new medications and treatments — that are

not as effective as lower cost natural or generic therapies.

If the procedure is done by

the recommending physician and is a source of their income, then there is

a heavy bias to believing that it is good for the patient. I remember

decades ago while in my internal medicine practice that recommending a

special heart monitor called a " holter monitor " was quite

profitable. As a physician, I was easily convinced that this would save

people's lives by picking up dangerous abnormal heart rhythms for

treatments. I remember the resistance I had to believing new research

showing that this test was overdone. Yet it turned out that it was.

Because of this, it is good to get a choice of treatment

options, preferably including natural options. Natural options will have to

come from a holistic physician, as most standard physicians are taught that

natural remedies are quackery — which in medicine is often just another

way of saying the option is " not good business. " A good holistic

physician is more likely to guide you based on the science and research of

natural remedies (though there can also be financial biases in holistic

medicine).

3. What if I do the more conservative treatments recommended by

my first physician, or nothing at all?

For most medications or medical procedures, presume the risk is

a bit higher than reported, as most studies are done in " best case "

scenarios. Because of this, if the risk of a conservative approach is really

not much higher than the recommended treatment, I personally will tend to

choose being conservative. To put this in perspective, my reading of the data

suggests that deaths from medications and medical procedures is the fourth

leading cause of death in the US — and is largely ignored by standard

medicine.

4. In serious cases involving life-prolonging treatment options,

what are the differences in quality of life?

In cancer treatments, for example, it isn't enough to only ask

whether one treatment will prolong life over another. If the treatment prolongs

life by one week, but leaves the patient largely incapacitated for two months

when they only have six months of estimated time left, and the treatment leaves

the family bankrupt to boot, it may not be something you want to choose.

Nonetheless, many physicians have no clue whether a treatment will prolong your

life by a week or a year (the drug companies only give them whether there is a

statistical difference). Knowing the different benefits expected from different

treatment options, particularly when those treatments are likely to be toxic or

expensive, is a very important consideration.

5. Get the second opinion from a physician that has a different

background.

In general, if the first opinion came from a doctor in a

specific specialty area, consider getting the second opinion from someone of a

different but related specialty. If getting a second opinion on surgery,

consider getting the opinion from a non-surgeon.

6. Consider getting a second opinion from a holistic physician.

A holistic physician can offer a very different set of options

(visit the American Board of Integrative Holistic Medicine

for help finding one).

7. Bring a friend and a tape recorder with you.

Finally, bring a friend, family member or other advocate with

you during the physician visit, along with a tape recorder. Ask the physician

if you can record the visit so that you can review and better understand what

they told you. Because of the legal climate, some physicians may be

uncomfortable with the visit being recorded, and if this is the case honor

their feelings (or the information they give is likely to be so hedged as to be

useless). Personally, as a physician, I have encouraged my patients to record

their visits for over 20 years (and had a tape recorder in my office that they

could use), as it helped me to give them the needed information more quickly

and clearly.

Love & Blessings,

Dr. Teitelbaum