Second opinions have become an accepted part of medical practice. Faced with uncertainty about a diagnosis or complex treatment, patients are often encouraged to get another perspective.
Many insurance companies will pay for a patient to be evaluated by a different doctor. Some even require a second opinion before they give the green light for an unusual treatment or surgery. Before spending money and subjecting the patient to risk, the company wants to make sure that the problem has been correctly identified.
The Trouble with Misdiagnosis
No wonder they worry: misdiagnoses are all too common. One study found that half of pediatricians responding to a survey admitted making a wrong diagnosis at least once a month (Pediatrics, July, 2010). The most frequent slip-ups reported were mistaking viral for bacterial illnesses and not identifying medication side effects.
Adverse Reactions to Drugs
Children aren’t the only ones who suffer from diagnostic failures, especially when it comes to drug side effects. Adults often report adverse drug reactions that go unrecognized for months.
“My 81-year-old father is fighting for his life after being on amiodarone. He is in the ICU with pulmonary fibrosis. The doctors keep calling it ‘idiopathic’ fibrosis because they do not want to admit amiodarone caused this illness.
“He was healthy and active and had never been on medication before. His cardiologist sent him home with a bottle of pills and never told him that a side effect of amiodarone includes pulmonary fibrosis. If he had not taken the drug, he would be playing golf today.”
Amiodarone, used to treat serious irregular heart rhythms, is known to cause scarring or thickening of the lungs in up to 9 percent of the patients who take it.
Dot had this experience:
“I cannot believe my doctor kept me on lisinopril when I am sure he knew the side effects. I started it in February and reported a tickle in my throat to him. Now it is June and that tickle has turned into a horrible cough. I am afraid to go anywhere for fear of having a coughing attack. I can’t sleep at night, so I’m constantly tired. I came off the drug two weeks ago, but I am still retching from this cough.”
Lisinopril is an effective blood pressure drug, but cough is a common and well-recognized side effect. We are puzzled that Dot’s doctor did not immediately identify her troublesome cough as a reaction to lisinopril and change her medication. Her story is far from unusual, however. Many people have suffered numerous expensive diagnostic tests for such a drug-induced cough.
Why Second Opinions Matter
These are just a few examples why second opinions should be available for medications as they are for surgical procedures or cancer diagnoses. A different doctor may be more objective than the prescriber and thus quicker to spot adverse drug events.
We offer “Top 10 Questions to Ask Your Doctor When You Get a Prescription” in our book, Top Screwups Doctors Make and How to Avoid Them.
Ask the Pharmacist
Patients can also get a second opinion on their medications from a pharmacist. This knowledgeable health professional may be reluctant to second-guess the doctor, but he or she can certainly provide information on risks, benefits and side effects.