I have blogged previously about the importance of seeking a second opinion after receiving a serious diagnosis (see, for example: Paging Dr. Google! We Are Waiting for a Second Opinion; Seeking A Second Opinion as a Partial Solution to the DCIS Controversy). A recent article provided fresh information about second opinions based on a recent study (see: Why You Should Always Ask For A Second Opinion). Below is an excerpt from it:
Of 286 patients who sought a second opinion from the [Mayo Clinic] clinic over a two-year period, 88 percent received a diagnosis that was either modified or completely different from the first one they received. Sixty-six percent of patients received a refined diagnosis and 22 percent received a completely different one....Only 12 percent received confirmation that their original diagnosis was complete and correct.....The study involved patients with provider referrals for a second opinion, meaning their first diagnosis was serious or complicated enough to warrant more attention....“Our study should not be interpreted to say that 20 percent of all diagnoses are wrong, [said an author of the study]” “However, it is also important that health care reform efforts do not prevent patients from getting second opinions when their providers feel they need further study or when the patient is not responding as they expected.”....Seeking a second opinion was once considered routine advice for any serious diagnosis. But for several reasons, that’s not always the case today. One reason is that health insurers often restrict patients to care within their provider network, effectively limiting referrals in an effort to manage costs. Patients’ reluctance to seek a second opinion is often based on finances....Many insurers won’t pay for diagnostic or other tests to be redone....Patients who see an out-of-network specialist for a second opinion may encounter significantly higher out-of-pocket costs, particularly if they subsequently want to receive treatment from that provider. They may also use online second opinion sites like the Cleveland Clinic’s MyConsult service, which is one of the most recognized. Getting a second opinion from MyConsult costs $565, plus $180 if a pathology review is required. The service does not accept Medicare or any private insurance at all ― just credit cards or checks ― though patients can submit their bills for reimbursement if they have out-of-network coverage.
This article makes the important point that some patients may be financially constrained by their health insurance when seeking a second opinion. This is because some insurers will balk at having diagnostic studies repeated. I suspect, however, that there will only infrequently be a need to repeat radiology studies like CT scans and MRIs. But and as noted above, it's probably worth the cost to pay out-of-pocket for a surgical pathology review as part of a second opinion because the interpretation of a tissue biopsy can sometimes be subjective.
Citing the Mayo study above, 88% of patients received a second opinion that was either modified or completely different from the first one they received. This data probably overstates the likelihood of having a diagnosis changed or modified as the result of a second opinion. This is because the circumstances that initially prompted the Mayo second opinion such as lack of confidence in the first opinion or the presence of a complex clinical picture. At the end of the day, however, seeking a second opinion does promote peace of mind. It should also be kept in mind that a second opinion may lead to a different, and perhaps better, therapeutic regimen or access to a previously unknown clinical trial.