August 31, 2015

Providers see surge in second opinions

Daily Briefing

An increasing number of patients are seeking second opinions, and a range of new services from providers like Cleveland Clinic are making the process easier than ever, Sumathi Reddy reports for the Wall Street Journal.

According to Reddy, research suggests that up to 20% of patients now seek second opinions—in certain specialties like oncology, half of patients obtain a second opinion. Insurance companies sometimes require a second opinion before covering a specific treatment.

The increase in demand, Reddy says, comes as more employers are contracting with online second opinion services. Plus, online tools have made the process easier, sometimes requiring patients to simply forward their medical records to get an evaluation.

Massachusetts General Hospital launched an online second opinion service about eight years ago. Gregory Pauly, COO of the Massachusetts General Physician Organization, estimates the service consulted with fewer than 1,000 patients five years ago. Last year, that rose to 10,000 cases.

And Cleveland Clinic's MyConsult service, launched more than a decade ago, has seen an icrease in patient volume of between 15% and 25% in recent years, according to Jonathan Schaffer, managing director of the service.

Beth Moore, EVP of program strategy for the Patient Advocate Foundation, says patients often look to second opinions when faced with serious illnesses, or are seeking treatment options that are less invasive, have fewer side effects, or are more personalized. "You don't always know what's available unless you seek a second opinion," she explains.

Second opinions, Reddy notes, also allow patients far from academic medical centers or advanced providers to access well-regarded specialists.

Why second opinions are getting a second look

The effects of second opinions

Data suggest second opinions have a real effect on treatment. Hardeep Singh, a patient safety researcher at Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, recently published a study of nearly 7,000 second opinions processed by Best Doctors, which provides second opinion services to insurance companies.

Overall, the study found that a second opinion resulted in a different diagnosis 15% of the time, and suggested changes in treatment 37% of the time. About 60% of patients followed the new recommendations, but Singh says the data reveal little about the quality of the new information. "We don't know whether the ultimate diagnosis for these patients ended up being the correct one," he notes.

Those numbers are similar to data from Cleveland Clinic. Schaffer says doctors in MyConsult reach a new diagnosis about 11% of the time and recommend significant changes in treatment in 16% of cases. "These numbers can have some pretty significant health care implications," he says (Reddy, Wall Street Journal, 8/24).

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