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Get a Second Opinion

Medicine is considered a science. But it takes the skill and experience of a doctor to interpret the scientific evidence in order to diagnose and treat our illnesses. Doctors rely on medical history, physical examination and tests. How your doctor interprets the evidence is the key to diagnosis and treatment. Yet, different doctors looking at the same set of facts may come to different conclusions. Often, the patients has to sort out what doctors tell them and figure out whose opinion to rely on.

Medical decision making depends on many factors, including interpretations from the behind the scene doctors; radiologists and pathologists. Radiologists interpret x-rays, CT scans, MRIs, and other tests that produce a visual image. Pathologists look at specimens, blood, tissue and organs in order to identify disease processes. For example, if a lump on a breast is identified, a portion of it will be cut out and sent to a pathologist who will report on whether there is cancer or not. However, two pathologists might interpret the sample differently. The same thing happens with radiologists. Two radiologists can look at the same image and come to opposite conclusions. Obviously you aren’t going to ask that every x-ray, CT scan or MRI be read by two or more radiologists. But, as Patrick Malone recommends, it is a good idea to get a second opinion where: (1) the test is read as normal “but your body is telling you that something is wrong”; (2) the report reflects uncertainty on the part of the radiologist; (3) the report doesn’t address the reason for the test; and (4) the report is generated by a general radiologist, rather than a sub-specialist radiologist.

Another area where second opinions are vital is when surgery is involved. First and foremost, make sure you have a good surgeon. All surgeries have inherent risks. Complications from general anesthesia, risk of infection and bad outcomes happen all the time. If a doctor is recommending surgery, ask a second surgeon for his or her recommendation.

Another thing to check before going under the knife is to find out all about your surgeon and his/her qualifications.In Georgia, the Composite Board of medicine has a web site where you can check out where your doctor went to medical school, where s/he was trained, the type of special training the doctor has and if the doctor is board certified. See our February 6, 2013 posting for additional information about choosing a doctor.

If you know a nurse who works in the hospital, ask her about the doctor. Nurses see the doctors every day. They know how the doctors treat their patients, and the nurses who work in the operating rooms see the surgeons at work every day. In recommending a surgeon, your primary care physician usually relies on the surgeon’s reputation, although we had one case where the only reason a doctor gave for calling in the particular specialist was that he had the specialist’s cell phone number. Before you let a doctor cut you open, do your homework.