Good Chance you have a Wrong Diagnosis. The Importance of Second Opinions.
Posted , 8 users are following.
A recent report from the Mayo Clinic states that as many as 88% of all medical diagnosis are wrong! Let that sink in. That means that if you've only seen one doctor, the chances are almost nine out of ten that you may end up being treated for the wrong condition!
Personally, I'm not surprised, in fact more surprised that people simply accept what their doctors tell them at face value after sometime no more than an exam that lasts minutes.
The recommendation, and pure common sense, is to get a second opinion for at least any significant diagnosis that can impact your life such as bph/luts with most of us here.
In general, the best place for a second opinion is a major medical center where the doctor who made your initial diagnosis is not affilited with. If you get a second opinion within the same organization, or with a doctor affiliated with your doctor's hospital, the second opinion can often be tainted by medical politics or peer influence.
Related, second opinions are also very important in terms of radiological findings. Recently here, a well well respected interventional radiologist diagnosed tumors from a 3T MRI Scan only to change his mind after the scan was reviewed by another radiologist. Had there not been two opinions, an unecessary operation might have been performed. This happens all the time. And if it were me, I'd probably get a third opinion in this instance from one of the second opinion radiology services such as the one Mayo has. You just send them the scans, no need to travel or see a doctor as I understand it.
Most people here are diagnosed with BPH because of lower urinary tract symptons (LUTS). But in fact many cases of LUTS may have nothing to do with BPH. For one example is that it could be a problem with your bladder. And yet, doctors all too often group the two together (BPH and LUTS) and reflexively offer a surgical solution if medications don't work.
I will post a link to the Mayo report in my next post, but it will probably take a day or two for it to go through the moderation process. For those who want to see the report sooner, google "Mayo Clinic researchers demonstrate value of second opinions".
Jim
1 like, 32 replies
ianC jimjames
Posted
I agree with jimjames. Doctors only advise; patients decide (that's why they get you to sign the form - it says it is YOUR decision).
Most doctors, I believe, give genuinely their best advice. That doesn't make them right, but it is based on a wider range of patients than any individual patient is likely to have known. However, their diagnosis and prognosis is based on averages, those in turn reflect, necessarily, historical events rather than the latest treatments.
Having said all that, when it is a matter of life or death (if not for less serious illnesses), then it is taking a big risk to decide only only one doctor's opinion. I consulted five before I got one who, it turns out, gave the best advice - the previous ones had consigned me to death in a few weeks.
Dr Google is great to give more information, provided one is cautious and goes by the 'weight of evidence' approach; and especially if a patient finds a forum like this one for their particular ailment.
kenneth1955 jimjames
Posted
That is very true. That is why a second or thrid opinion is a good Idea. When a man has a problem with going to the bathroom they automatically assume it the prostate and right away they want to start cutting away. If you ask some of the doctor maybe it the bladder they say maybe but if we get rid of the prostate you will pee better. That right there is a sign to look the other way and find another . It is now alway the prostate that is causing us the problem it is the bladder. Make sure you have any test you have to to make sure things are going to be right. Not do a surgery take out 80% of your prostate and find out it the bladder. The doctor can't put it back and he will have nothing to say. Information is the key Thanks Jim this will help many men Ken
stebrunner jimjames
Posted
Hi, Jim,
Your Mayo stats are scary, but believable. I want to believe that doctors have our best interest at heart, but sometimes I wonder. "Trust but verify" seems to be the way to go.
Just last week I had a 2nd opinion before my hernia surgery. The surgeon told me I had a 2nd hernia, an umbilical one. He went on to say that he'd repair that while repairing my inguinal hernia--and only charge another $1,000. It felt like an "add on" sale to me so I declined. I may very well have one, but later I wondered why it hadn't shown up on my recent CT scan--and why the 1st surgeon I consulted didn't catch it.
BTW, the 1st surgeon I consulted with was local--the 2nd in Florida. The 1st one said in his report that my hernia was on my left side--and it was actually on my right side. When I called his office about this mistake, his nurse told me not to worry about it--that the doctor would correct the report it the next time he saw me. That did not inspire confidence in the surgeon or his staff.
My urinary adventures have taken me from local doctors to ones at the University of Washington Medical Center in Seattle, to the Mayo Clinic in Phoenix and to RIA Endovasular in Denver. Some of the best advice and informaiton I've found has come from this forum! I'm very fortunate that my primary care doc is completely supportive--but then again, she's in a very small, independent practice. I credit her with saving my kidneys. If I had depended upon the big hospital system in town, I probably would've lost them.
Stebrunner
Howard31850 jimjames
Posted
Hi Jim,
I wonder how much of these mis-diagnoses is due to reliance on expert system and artificial intelligence rather than just thinking about the problem and using training and intuition. My old PCP retired a few years ago and I don't think ever misdaignosed a problem. But his replacement is a young techy who just inputs symptoms to her "smart" phone which ties in to the main computer that spits out a diagnosis. She has yet to be correct on any of our problems, even with obvious things like a torn meniscus (me), a UTI (me), or pneumonia (my wife).
Having said that both my parents and my wife's parents died because of mis-diagnoses by prominent doctors in prominent hospital settings. It is very sad and scary especially given how much we spend. Technology is no replacement for thinking about the problems. Gee .. now I scare myself about going in for my procedure next week .. oh oh
jimjames Howard31850
Posted
I don't think they really teach logic and deductive reasoning in med school which IMO is key for proper diagnosis. It seems more like "cookbook" medicine, so if you present this and that, then you get this or that.
That's scary about the young techy who puts symptons in the smart phone. I mean, I do that myself online but I will often send hours online comparing guidelines and studies while I guess your young techy takes about a minute. And that's what you get, about a minute's worth of thought.
I have had a few doctors over the years that actually listened and thought things through but even then it was usually only after I challenged their diagnosis with my own research. Most of those guys are either retired now or have opted out of all insurance plans.
Recently, found a uro I wanted to see, and one of the questions I asked the appointment person was how long does spend with me on my initial visit and will it be just him or a PA. Well, I got the answer I was looking for. It's just him and he usually spends 45 minutes to an hour but longer if needed. Only problem was he didn't take insurance and the consultation was $800. If it was a one shot thing I probably would have done it, but I was really looking for a go-to urologist, so working with someone who take Medicare makes more sense. That said, still without a urologist who can give me any more information than I can figure out by myself.
Jim
Howard31850 jimjames
Posted
Hi Jim,
You sure know how to start a lively thread!
I read your link (thanks) and to me it just seems like an advertisement for the Mayo Clinic! What thye didn't say in the article was how did the patients make out whose diagnoses they changed? That is what matters.
The assumption in the article is that the Mayo clinic was correct and the other doctors were wrong. So the Mayo clinic changed 88% of diagnoses - but what does that mean? To me it suggests that they are just trying to drum up business for themselves. I kept waiting for the guy to say that they then followed up on the 246 patients and the majority had good outcomes.
It reminds me when we looking for a new car a few years ago. Each dealer would trash to other dealer. So we wnet to car forum on the models we were looking at and got the truth.
We need a forum made up of patients who had their diagnoses changed by the Mayo clinic so we can follow their outcomes. Now if the Mayo clinic was correct 88% of the time then sign me up!
Thanks for another great topic.
Neil
jimjames Howard31850
Posted
Neil: The assumption in the article is that the Mayo clinic was correct and the other doctors were wrong. So the Mayo clinic changed 88% of diagnoses - but what does that mean?
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Does it matter who is right or wrong
Someone is wrong 88% of the time 
And maybe Mayo is trying to drum up business but that doesn't take away from the fact that diagnosis' are messed up all the time. Nothing new but 88% is a real wake up!
I think the real message is definitely get a second (or third) opinion on important stuff; in addition do your due dilligence with outside research, and then make what you think is the best decision for yourself.
I'll admit it can be confusing getting different opinions, but I've found that by the 3rd opinion (assuming you pick the doctors well) some sort of clarity seems to float through the cloud.
Jim
Howard31850 jimjames
Posted
Hi Jim,
OK - so here is the lesson for all of us:
When we go to a doctor for a second opinion DON'T TELL HIM it is for a second opinion! Just go as a new patient and present your problem to him and see how his diagnosis compares to your first one. Don't take any records or tests and just play dumb.
I'll bet those doctors at the Mayo clinic had the initial diagnosis records for all the patients in the study. I wonder what their diagnoses would have been had they not had access to these initial records. Perhaps they woul have been the same for the majority of cases.
Then it is up to the patient to look at the two diagnoses and make a determination. This approach also gives power back to the patient.
Neil
jimjames Howard31850
Posted
I mentioned that before, not telling the doctor. And when tests are involved that I don't want to take again, I've gone so far as to photoshop out the name of the doctor who requistioned the tests and the hospital where they were taken.
The other thing is that by the second or third opinion, you start to get smarter and more informed so you can ask better questions and when necessary play devil's advocate to help them think.
It's not an easy game
Jim
jimjames Howard31850
Posted
jimjames Howard31850
Posted
Just want to add that from what I've seen, you certainly have done your due dilligence. No one, including Mayo, can tell you whether the G-G like procedure is the right choice because you, yourself have already thought things through properly. I wish you the best luck with the procedure. BTW not sure if I mentioned I think I have those veins as well, so will be following this closely.
Jim
Howard31850 jimjames
Posted
Hi Jim,
Thanks for the good wishes - they all help a lot.
No - I don't have anything against the Mayo or any other place but I thought the article should have been placed in the "Paid Advertisement" section of the AAAS.
This study would have been thrown out in a lab for being "contaminated".
But we all have to expect that if we go to a place that has a certian specialty then that this is the treatment they will offer and say it is the best.
Personally i would not even take old tests with me but rather see if the new doctor wants to order the same or different tests and if the same then see how those test results compare to the ones you already have. There is a lot variability between centers.
You know, my uros trash each other because they offer different procedures for BPH and then they all trash the VIRs. Meanwhile the VIRs trash the uros an each other too. Recall that Dr. Gat is a VIR. And then of course many of them treat their patients like idiots with health insurance ot cash.
Again the only hope for us is forums like this one.
The problem you identify also extends to biotech and drug companies that develop new drugs. There is a crisis in this field now because claims made by one lab cannot be duplicated and confirmed by another independent lab.
Thanks Jim.
Neil
Waffalobill Howard31850
Posted
Not sure if you saw our conversation before Neil. But they have started linking medical records in our state. I even went out of town to a place has nothing to do with any health care around here to see a specialist I can't get in my area. They had my history already. They are trying to curb doctor hopping and going to other hospitals getting scripts for meds.
Howard31850 Waffalobill
Posted
That's not good - more big brother. It means we would have to go out of state then to keep our privacy.
Waffalobill Howard31850
Posted