This is a follow-up to my Remarkable Medical Statistic post of February 13, which referenced a study that found that 88% of those who sought a second medical opinion received a refined or new diagnosis. (Tony White commented on that post and identified a flaw: Because the study consisted of people seeking a second opinion from the Mayo Clinic—a world-class facility—their diagnoses were much more likely to be upgraded. But, even if a little biased, the study remains enlightening.)
Perhaps even more interesting and relevant than the study cited in that post, is the idea of seeking multiple opinions for treatments following a diagnosis.
Many years ago, I read about a study in which the medical history of a patient was sent to four different kinds of doctors, each of whom suggested a different course of treatment. I remember what two of the four suggested treatments were: 1) an internist who recommended medications and 2) a surgeon who recommended surgery. I will now speak to my own experiences here, which I think will prove instructive.
At one time, I had heartburn/reflux and consulted a doctor who suggested medication. This did not help, so I saw two other doctors, both of whom recommended surgery. I was not ready to do that (it wasn’t serious enough), so I did my own research on the causes of heartburn/reflux and how to manage it. And since managing it myself with simple treatments like avoiding certain foods, raising the head of the bed a few degrees, and just not eating for two or three hours before sleeping, I haven’t since had a problem with heartburn.
Another case: I wanted to have some fairly major dental work done, so I got referrals and researched and visited four highly recommended practices, from Beverly Hills to Orange County. At the third practice I visited, the dentist I spoke with was thoughtful and highly qualified, so I decided to go with him. However, I figured I would still check out the last one, Dr. Greg Guichet in Irvine. The difference was just so apparent—from the waiting room, to the reception, to the quality of the staff, to the quality of his practice. If you can imagine it being a pleasure to go to a dentist, it’s a pleasure to go and see Dr. Guichet and his team. (He practices with two of his brothers, who are also dentists.)
When I needed a hip replacement, I had research done in order to find a highly qualified surgical team. One of the most important criterions for anyone performing any surgical procedure is how many of those procedures they conduct each year. As a result of this research, I found Dr. Thomas Schmalzried. He has a remarkable practice, a remarkable team… and that was over 10 years ago. I’ve never had any problems with the replacement, and, what’s more remarkable, 90 days after the surgery I was skiing again… not super-fast or aggressively, but skiing nonetheless.
I followed a similar process with my sinuses. I had a chronic sinus problem… something one gets from living high in the mountains at Lake Tahoe. I was recommended medications, various irrigation techniques, and so forth. But finally, I needed to get something serious done. I consulted at least five physicians who practiced sinus surgery, ranging through various techniques. In some cases, I visited them in their offices and in others I simply paid for half-hour consultations via Zoom. I had to pay cash for these consultations, but it was well worth it. I finally found an extraordinary doctor, Dr. Brian Weeks at the Senta Clinic in San Diego, who did a balloon angioplasty. It was a miracle. I’ve had no problems since.
So, now you know just about my entire medical history (HIPAA be damned 😊). For me, second, third, or fourth medical diagnoses are necessary. But second, third, or fourth opinions are also useful when it comes to determining a course of treatment. In fact, that’s when I believe it becomes particularly important.
I hope this information is of help. Please feel free to pass this along to anyone you wish.
The study of medicine is science—some of which is truly settled, some of which is still in development—along with a lot of speculation. The practice of medicine is an art. And, as with any art, the quality of the art depends upon the experience and skill of the practitioner.
Carl B. Barney
September 22, 2023