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Why it’s important to get a second opinion

Second opinions can lead to a more refined diagnosis, researchers say

When illness strikes, many consumers head to their doctor seeking a diagnosis. And while they may receive one, a new study suggests it may be in a patient’s best interest to obtain a second opinion before following through with treatment.

For patients with complex conditions, new research shows that a second opinion can lead to a more refined diagnosis, more effective treatment, and reduced stress in a patient’s family.

In a new study, researchers found that 88% of patients who went to Mayo Clinic seeking a second opinion ended up changing their care plan after receiving a new or refined diagnosis.  

Only 12% of the 286 patients who were referred from primary care providers to Mayo Clinic’s General Internal Medicine Division left the facility with confirmation that their original diagnosis was complete and correct.

Identifies diagnostic error

Second opinions can lead to quicker access to lifesaving treatment and may even keep patients from undergoing unnecessary treatments, said lead researcher Dr. James Naessens. They can also reduce stress in a patient’s extended family when they learn that the new diagnosis does not carry dire genetic implications.

“Effective and efficient treatment depends on the right diagnosis,” said Naessens, a health care policy researcher at Mayo Clinic.

“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," Naessens said in a statement.

Why referrals are often limited

The researchers explained that several factors may prevent patients from receiving a referral for a potentially lifesaving second opinion. Reasons include:

  • Limited access from health insurers to receive care outside their network
  • A physician who feels confident in their diagnostic expertise
  • Lack of knowledge or assertiveness on behalf of the patient to request a referral

Factors like these “may prevent identification of diagnostic error, and could lead treatment delays, complications leading to more costly treatments, or even patient harm or death,” said Dr. Naessens.

Regarding the costs associated with second opinions, Naessens noted, “Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly.”

Naessens and his colleagues plan to conduct further research on diagnostic errors to identify ways to improve the process.

The full study has been published online in the Journal of Evaluation in Clinical Practice.

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