December 3, 2023

By John Rossheim | NerdWallet

Why spend the time and expense to get a second opinion in case your physician recommends surgical procedure or they diagnose a critical illness? In spite of everything, you’ve been examined, examined and evaluated by an knowledgeable with a few years of coaching.

However the harsh actuality is that misdiagnosis occurs rather a lot — and generally with the gravest penalties. Annually, roughly 371,000 folks within the U.S. die due to diagnostic error, in line with a July 2023 research within the medical journal BMJ High quality & Security.

A medical second opinion can enhance the probabilities that you just get the proper therapy from the beginning, saving cash, misery and perhaps your life.

“Second opinions are most likely the only quickest strategy to handle diagnostic errors immediately,” says Dr. David Newman-Toker, director of Johns Hopkins Drugs’s Middle for Diagnostic Excellence.

Seeing the precise specialist or subspecialist could make all of the distinction. “We all know [from research] that if a affected person with sarcoma is seen at a sarcoma middle, their survival is longer,” says Kristen Ganjoo, a medical oncologist who teaches at Stanford College’s College of Drugs.

What’s a second opinion, and why is it beneficial to you?

Second opinions — whether or not to assessment a surgical procedure advice or a most cancers analysis — sometimes require a step-by-step reexamination of a affected person’s case.

Step one is to assessment the prevailing analysis, in line with Ganjoo. For instance, sufferers may have a pathology assessment at an establishment that has consultants in sarcomas, she says. “We have now 100 several types of sarcoma, and so they’re all handled otherwise. If a pathologist will not be conversant in sarcomas, they could make a mistake in diagnosing sufferers.”

Subsequent, Ganjoo determines whether or not the affected person wants extra exams, equivalent to a scan or an evaluation of a tissue pattern for genetic mutations.

Lastly, she evaluations the therapy plan and makes any needed modifications to it, primarily based on all take a look at outcomes and her analysis.

However second opinions aren’t solely about coming to the proper analysis. They are often about “what’s the very best therapy for this explicit affected person at this level of their life,” says Caitlin Donovan, a senior director on the nonprofit Affected person Advocate Basis, which works to teach and empower well being care shoppers.

“How are you going to incorporate quality-of-life issues and nonetheless get the outcome you need?” says Donovan. “Physicians could differ on that.”

What does a second opinion value, and does insurance coverage cowl it?

Expenses for a second opinion differ extensively, as does insurance coverage protection.

Some main medical facilities supply a second opinion service at a set worth. A digital second opinion on the Cleveland Clinic prices $1,850. Stanford Drugs costs $700 for a web-based second opinion. The bundle of providers supplied — and the medical workers’s data of explicit specialties — differ by establishment.

In case you are insured by an employer or via a state or federal medical health insurance market, contact your insurer to ask about your protection for second opinions for folks along with your analysis.

Medicare could pay at the least a few of the value of a second opinion when surgical procedure is really useful. Medicaid gives some protection of second opinions; name your state’s Medicaid workplace for particulars.

You could possibly pay any out-of-pocket prices of a second opinion via your well being financial savings account (HSA) or versatile spending account (FSA).

Monetary help for second-opinion bills for sure diagnoses could also be obtainable via a wide range of organizations, together with the Affected person Advocate Basis and the Sarcoma Alliance.

In case you are shy about asking for a second opinion

Some sufferers are embarrassed to let their physician know that they’d prefer to get a second opinion. However for those who do encounter resistance, know that you just’re pursuing an affordable plan of action.

“Any good doctor goes to encourage you to discover your therapy choices,” says Donovan.

“Typically you simply have the improper clinician,” says Newman-Toker. “They’re overconfident or they’re not concerned about asking deeper questions or listening to your issues as a affected person. Then, you simply want a brand new physician.”

Avoiding misdiagnosis

Newman-Toker gives the following pointers:

  • Come to your appointments ready with a easy, printed abstract of your timeline of signs and issues, to depart extra time for dialogue and questions.
  • Ask laborious questions, equivalent to, “What’s the worst factor that this might be, and why is my situation not that,” says Newman-Toker. If the physician bristles, take into account going to a different. “It’s a must to depend on asking probing inquiries to see in case your doctor is dedicated to getting it proper.”
  • After therapy begins, stay vigilant, Newman-Toker says. “Don’t assume that for those who don’t get a superb outcome, your therapy must be adjusted, somewhat than your analysis reevaluated. Possibly it’s time for a second opinion.”