Second Opinions

Man: “I have a big date tonight. How do I look?”
Man’s friend: “I don’t like your shirt.”
Man: “Maybe I need a second opinion.”
Man’s friend: “I don’t like your trousers either.”

Second medical opinions

I will be honest. I generally am not a big fan because basically I am not a big fan of...first opinions. The first opinion is traumatic and bothersome enough. The initial phone call, the several text appointment reminders, the multiple waiting rooms, the diagnosis, and the bill. Who can stomach it? And then to do it again?

Avoiding a misdiagnosis

Now, I do understand the value of first and second opinions. If I have a question as to whether my doctor missed something, I will undoubtedly try to find the answer elsewhere. After all, this is my body and my health. This is not about what I am wearing on a date or outing, but whether a mole is melanoma. I will find out whatever it takes. A misdiagnosis or under-diagnosis cannot be ignored and may require a second pair of eyes.

What is over-diagnosis?

But, what about over-diagnosis? Is that even a thing? Recently I came across an article that made me consider the possibility that people are being over-treated, that they are improperly “over” diagnosed resulting in unneeded stress, trauma, expenses, and wasted time and energy. I almost hesitate to bring this up because I would never want to give anyone reason to not get checked for skin cancer.

Is over-diagnosing hurting everyone involved?

A recent online article from Australia concluded that over-diagnoses for all types of cancers, including melanoma, was a significant issue for patients, providers, and the general medical community. Associate Professor Kay Bell of the University of Sydney noted that patterns of increased testing, incidences of cancer, and treatment without a coinciding rise in mortality could be the result of over-diagnosis.¹ But could this be the result of better treatments, better information leading to increased testing and more diagnoses?

Early detection is always important

The article is quick to point out that getting the right balance between too much and too little screening is critical. It goes on to encourage patients to be vigilant when it comes to early detection and diagnosis. Patients must be informed and work with their providers in making shared decisions regarding treatment.¹ But what about getting a second opinion when you think that you may be over-diagnosed? If people are routinely being over-diagnosed (as the research article found), then is seeing a second physician before any involved procedures a good idea?

A second opinion may not be a bad idea

I think so. If you have any doubts at all, whether you feel under-diagnosed or over-diagnosed, whether you feel your physician missed something or made a mistake, then get another opinion. I like to get a few estimates when it comes to repairing my car or home. Why wouldn’t I want another opinion when it came to a course of treatment to repair my body? Have you ever taken your auto to the shop and you received a quote for $500 and then took it to a second shop and they turned one screw and fixed the issue for free?

Now, I am not saying that doctors are purposefully missing things to over treat for some terrible motive, but they do make mistakes. They are human. Even a different perspective can mean the difference between a relatively involved treatment and something less involved but as effective. Food for thought.