New companies are lining up to help us make better medical decisions
Recently, the New England Journal of Medicine published a story of one oncologist’s experiences. The doctor writes about a new patient “scrunched up in bed, tossing and turning, his sheets tangled between his legs. He’s pale and uncomfortable, licking his lips, his IV fluids having run out. My immediate impression is that he’s dying. But I remind myself that he’s scheduled for surgery.” Despite doubts, the oncologist signs the patient off to his perceived superior, the surgeon, and the patient dies after a procedure he’s not strong enough to survive. It’s not an uplifting tale.
According to a 2010 Gallup poll, 70% of Americans trust their doctor’s advice so much that they never get a second opinion or do additional research. We spend more time researching which clothes to wear, buying HD TVs and even which resturant to eat dinner at. All of us should get our heads examined. Or, a second opinion and re-examined.
Medical errors in the U.S. cost about $20 billion a year—not to mention lives. A new health-care documentary, “Escape Fire,” notes that when you give doctors big rewards for doing certain procedures ($1,500 for putting in a stent versus, say, $15 for talking to a patient), that’s what they will do. Such procedures may be not just unhelpful (the Congressional Budget Office says up to 30% of them don’t improve outcomes) but hurtful. A study in the New England Journal of Medicine in 2010 found that 18% of patients were actually harmed by medical care.
So while we most of us refrain from rocking the boat—our doctors want to be right, we want to be reassured—others have stepped in. Second surgical opinion programs were introduced in 1972 by insurers, to improve patient decision-making and reduce the risks, and costs, of questionable operations.
In 2009, the Right to a Second Medical Opinion Act did worse than the patients it was trying to help and died on a congressional committee table. Today, though, the private second-opinion industry has never been healthier, boosted by medical imaging technology (MRIs, CT scans) and the ability to instantly transmit and view large amounts of medical data. Employers increasingly include second-opinion programs in their benefits, offering independent specialists to remotely review cases and give advice—and, the companies hope, lower their own costs.
Wherever you are, confidence in your doctor varies little with educational level, more with age: Younger patients are the most skeptical. Though clearly aware of this demographic trend and obviously in it for profit, second-opinion companies do encourage us to talk back, with compelling results.
An estimated 60% of cases, an alternate treatment is recommended—often one that’s more conservative and cheaper. At the Elizabeth Wende Breast Clinic in New York state, second opinions led to the cancellation of 73% of 1,053 surgeries in favor of less-invasive options.
But this soon-to-boom business usefully reminds us that any authority is biased and fallible. More information is better, and when it comes to health, it pays to probe and keep probing. Being opinionated is fine. Being second opinionated could save your life.
