A Shopper’s Guide To Second Opinions

The Bulletin in Philadelphia published an interesting column from Herb Denenberg, A Shopper’s Guide To Second Opinions.

The second opinion is one of the great lifesavers in medicine. But it is underused for various reasons.

The need for second opinions can be better understood by considering the case of the pathologist’s report on a biopsy. One of the best discussions of this appears in a book I’ve discussed before, Patrick Malone’s The Life You Save: Nine Steps to Finding the Best Medical Care — and Avoiding the Worst.

Mr. Malone discusses the example of surgery to remove a cancer. The issue was whether the surgery was successful. To determine that, the pathologist will look at removed tissue and try to say whether the margins are clean, suggesting that the cancerous cells were removed. The pathologist may also have an opinion on how aggressive the cancer is.

Mr. Malone writes, “What laypeople don’t often know is that these opinions are fraught with possibility for disagreement and outright error, and that’s why getting a second opinion on biopsies  — and all other tests, for that matter — is one of the critical nine steps to taking charge of your health care.” Mr. Malone likens it to art critics attempting to decide if a Jackson Pollack painting is genuine. Art critics may debate with passion on that question and their opinions may be all over the lot. By like token, pathologists may also have a range of opinions and demonstrate far less certainty in reaching their conclusions than a casual observer might assume.

You've heard me say it many times, but the ease of getting second opinions with digital pathology is one of the key benefits this technology brings.