Skip to main content

Second Medical Opinion

By


When access to medical consultation is as easy and cheap as is in India, that many patients, especially those with resources, would seek more than one expert’s opinion, is only to be expected.

“Second opinion” is the seeking of another medical opinion to verify or validate what the first doctor had diagnosed or advised, and is often quite a valuable step. if an otherwise healthy person who has had no symptoms of disease till yesterday, is suddenly told to have liver cirrhosis due to a viral infection that requires long and expensive treatment, it is imaginable that he and his family may like to verify the test results, explore if there are other management options, weigh the pros and cons, and particularly in our country, see if they can get the treatment at more affordable rates, before they decide to start.

The diagnosis of cancer is certainly is another such situation. It often comes as a shock and evokes a sense disbelief and denial in patients with thoughts like “it just can’t be true, I just had symptoms of indigestion” or “it cannot be happening to me”. A second evaluation by a competent doctor re-confirming the diagnosis helps the patient to accept the unpleasant truth.

Indeed, good physicians and surgeons often advise their patients to consult a second physician so as to get convinced of the unpleasant diagnosis and then return with greater motivation to embark on a treatment that is challenging.

It is here that Indian doctors often fare badly and irresponsibly: most end up contradicting the previous one with an attitude of one-upmanship, change the names of medicines in a fresh prescription, and try to “win over” and grab the patient rather than sending him back to the first one, leaving the patient more confused.

The line that divides “second opinion” from “medical shopping” is however a blurred one.

Medical shopping is quite akin to what we do while buying vegetables, going from one grocer to another enquiring the rates of cauliflowers, seeing their size, and at times bargaining, before making our purchase. There are people who in their contrived habit of seeking the cheapest will enquire about the cost of endoscopy in 5 centres before going in for one. It may not always be the price, but the popularity of the doctor or the market-stature of the clinic instead which could be the choice determinant.

Once a “noveau riche” businessman’s wife in her 40s, brought her 12 year old daughter, As I went through her history and scanned the results of the innumerable ultrasound and CT scan tests she had gone through, the mother proudly told me that she had consulted 18 of the top pediatricians, surgeons and gastroenterologists of the city.
She was obviously in a “number game”, trying to satisfy herself that she had not left any stone unturned, but was losing out on any caring doctor who would be willing to take a personal interest to solve the child’s problem, knowing he would be just the next one in her unending list!

Comments

Post a Comment

Popular posts from this blog

Food Fads in Liver Disorders

By
In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...
2 comments
Read more

The Doctor’s Dress

By
The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to...
2 comments
Read more

Uberification of Health Care

By
The imaginative concept of matching transportation demands of people with cab facilities using a smartphone platform that Uber is credited to having created is now beginning to be applied to health care as well. At the outset, let me share with you what I understand of Uber. It is an on-line transportation company that develops, markets and operates the Uber mobile app, which allows consumers with smartphones to connect with Uber drivers through a software platform for taxi service. Uber itself does not own any assets such as cars, or hire the drivers. Uber was founded by Tavis Kalanick and Garrett Camp as recently as 2009 in San Francisco, but the impact and success of this “start up” has reverberated across the world, being now valued at US $ 62.5 billion. Fresh successful ideas in one domain often tickle the minds of entrepreneurs in other fields. Healthcare experts are now trying to explore if they can bring about a revolution in their sector as well. The proposition se...
Post a Comment
Read more