A Second Opinion on Second Opinions

New technology provides patients the ability to access second opinions from the comfort of their living rooms. But the technological also raises a number of questions about patient-initiated second opinions.

Medical travel means leaving home for care. But, when it comes to second opinions from practitioners around the world, the existence of companies that can provide direct-to-patient access means you don't necessarily need to leave your living room. We are not sure about how many international patients seek online second opinions, where they live, or the characteristics of the consultants, but we do know that, given the evolving nature of the global care ecosystem, that there are issues when a patient seeks a second opinion and does not coordinate it with their original doctor. Among the issues that arise are:

• Usefulness of opinion

• Liability

• Cultural competence

• Information exchange

• Continuity of care

• Payment and insurance covering

• Referral leaks

• Inter professional communication

• Translation issues

• EMR integration

In addition, add:

• Verifying patient ID

• Verifying doctor qualifications and credentials

• Truth in advertising

• State or regional board regulations

• Conflict of interest and disclosure

• Security and confidentiality

• HIPAA and other regulation violations using black market eCare

Most doctors encourage second opinions. Some discourage them.

The impact of second opinions on diagnosis in radiology and pathology is well documented; however, the value of patient-initiated second opinions for diagnosis and treatment in general medical practice is unknown. Given the issues and the questionable value for a given condition, it's time to get another opinion on second opinions.