When and Why You May Need A Second Medical Opinion

08/28/2017 05:10 pm ET Updated Aug 31, 2017

Second opinion: when and why you may need it?

When was the last time you had a surprising result from a medical check-up? Your physician apathetically informs you of the results of a blood test, an ultrasound, or an x-ray that spells trouble for your lifelong wellbeing. It can be easy for you to immediately begin burying yourself in an apocalyptic swell of emotions, but think about this first: did you know that medical errors occur in about 15% of all the diagnostic cases?

A research team of health care policy experts at the Mayo Clinic conducted analysis of 286 records of patients who have been referred to the Mayo Clinic's General Internal Medicine Division over a 2-year period. Findings from this study indicated that when patients pursued a second opinion, the original diagnosis was confirmed merely 12% of the time. Among those with updated diagnoses, 66% received a more refined diagnosis relating to the original, while 21% of the new diagnoses were in complete contrast to the original diagnosis of the initial medical professional.

Within the past twenty-five years, nearly 29% of insurance claims have been attributed to diagnostic errors, costing insurance companies almost $40 billion. Of course, one of the most saddening results of diagnostic errors, is death, especially ones that could have possibly been avoided by a quick consultation with another medical professional.

When is it necessary to seek for second opinion?

When you come face-to-face with a life changing health care decision, you may have a hard time knowing what your next best step should be. You will, undoubtedly, find yourself fielding dozens of questions within your own mind: Is that expensive procedure the only right choice? Is surgery really the answer? Is it best to agree to urgent treatment or wait for another solution?

While in some cases there may not be one right answer, to answer the big questions, it's a good idea to consult more than one doctor. This is what the second opinion concept is all about.

How to get started?

Many patients and health consumers sometimes have a worry that deliberately seeking out a second opinion will cause the initial primary care doctor to become offended. However, this concern is minute in comparison to the bigger picture: your health. Primary-care doctors may actually welcome, and even encourage, their patient seeking out feedback from other doctors, sometimes offering referrals from their own personal network. A great doctor understands your right to be informed, and their cooperation is necessary when medical records, especially test results, need to be released to another medical professional.

In cases where it is absolutely necessary, most insurance plans will reimburse at least part of the costs incurred with seeking out a second opinion. Medicare, for instance, will pay 80% of the bill for a second opinion, as well as 80% of the costs incurred for a third opinion, in the case of the second opinion being starkly different than the first. Patients with a Medicare Health Maintenance Organization plan (HMO) are entitled to a second opinion, though some plans will require a referral from your primary physician, and like most HMO treatments, you must see an in-network physician.

What are your other options?

More often than not, your insurance company may not be your greatest supporter, nevermind your friend, so it is not unlikely for your insurance to not cover enough, or any, of your second-opinion case. In that instance, technology is here to fill in the gaps.

San Francisco-based company ConsultingMD, for instance, promises to connect you with top doctors in the medical industry, in addition to an impressive claim of processing the second opinion within 48 hours. One downside of this service however, is that it will cost approximately $3,750, which is fairly pricy for individuals to have available out-of-pocket.

Another disruptive technology company in the healthcare sector is Los Angeles-based startup - Healpoint.io. According to the founder and CTO Boris Poly, the Healpoint platform is utilizing a blockchain technology to not just deliver one opinion from one particular doctor, but to empower a user with consensus on their diagnosis impacted by multiple doctors from around the world. This platform has the potential to totally change the industry of second opinions as it currently stands, especially when it comes to prices. Healpoint promises that the cost of the diagnostics will be almost 50% lower than the current industry standard is.

Whatever your situation, it is usually best to give yourself space to think through your next best step. It could not hurt seeking out a second opinion, but it has the potential to offer you greater options for your future. Who knows, your primary diagnosis may be confirmed, providing you with relief and confidence in the suggested treatment option. In the other case where your second, or even third, opinion is starkly different from the original diagnosis, you will be one step closer to recovery by being sure about your diagnosis.

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