Good Chance you have a Wrong Diagnosis. The Importance of Second Opinions.

Men's health
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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

 

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Mayo report here:

https://www.eurekalert.org/pub_releases/2017-04/mc-mcr033017.php

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Not sure bout where your from Jim but recently I had to fill out and sign papers that link all my medical records with all docs offices and hospitals. If I go to another doc for a second opinion, first thing they do is look up all previous docs and diagnosis given. Keeps ppl from going to several docs and getting multiple prescriptions for drugs , and going to multiple ER rooms for drugs. So there opinions get tainted before you even get a chance for second opinion. Most specialists there's a 3 month or more waiting list. Some longer. I recently seen a gastro. He wants to scope my stomach for ulcers. Lady found me a appointment at the end of May. That was the only date he had open before the end of October. Lol. I seen ppl in other places wait a year or more for apps. Think that makes ppl take that first docs word for it and stops them from getting a second one.

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Really good advice. I've had a few encounters along those lines. One of them could have proved fatal. The doc easily diagnosed me with giardia and didn't want to do further testing. I went for a second opinion where the doc did further testing, and in addition to the giardia, I had shigellosis which is potentially fatal. Second doc was an osteopath, and I have had fond feelings for osteopaths ever since!

On another note, I showed x-rays for possible perio work to 3 different dentists. I got three different opinions about what the situation was, and all 3 dentists were very sure of their opinions. Go figure! 2 of the opinions, while still different, recommended no perio work, so that's what I went with.

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The "diagnoses" provided by the members of this forum have far better statistics because we "live" with the consequences of the "professionals"!

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I'm in the U.S.  Sounds like you're UK?

I once went to a big shot specialist (not a urologist) and didn't only not like his diagnosis but didn't like him as well. So, I made an appointment for a second opinion at the same hospital. 

Getting along well with the new doc who was starting to go in another direction with the diagnosis, when all of a sudden she said while reviewing my records, "Oh, you already saw Dr. "X". Why are you coming to me then."  

At that point her diagnosis was over and I was out the door. Learned a big lesson there about not getting second opinions within a hospital group especially if the second opinion was down on the status food chain.

With radiology reports, I sometimes wonder the same, especially when they compare them to older reports. Of course, there is utility in having an image history, but on the other hand a truly fresh read might in many cases come up with something different.

I once underwent some treatment based on a biopsy report that was not prostate related. Later, I got a significantly different read by another doctor and realized that I had been pushed into a treatment I did not need at the time.

On the other hand, a second opinion can be reassuring. I sent one radiology report to a medical center specializing in second opinions for that particular issue. The report confirmed that I did not need any treatment. 

And that's just me!

Second opinions are tricky. On one hand you do want the doctor to know your history, but on the other hand the history can often taint the new doctor's diagnosis. Depending on the specific issue, I have sometimes gotten a second opinion and intentionally left parts of my medical history blank. Other times, not as much.

A few years ago I wanted a second opinion on bladder cancer which it turned out I didn't have. I felt it important for the second opinion doctor to see some of the lab work. Even though the original doctor was from a different hospital, they were both from the same area. I left the report in tact but photo shopped out the name of the doctor and hospital where the tests were taken. The new doctor never asked. Hopefully, he actually read them

I understand the idea behind linking all medical records with all docs, hospitals, etc. And maybe one day they will do it here as well. Just hope it's not for a long time.

Jim

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And ironically we probably actually take more time thinking about things! With some docs it seems that the diagnosis has been made before you walk in the door. As long as you fit into a basic mold, they often spout off the diagnosis almost immediately. I knew that but assumed they'd still be right at least in a majority of cases, which is still not very good. But this report shows they are wrong almost 9 out of 10 times in at least some aspect of the diagnosis. 

Jim

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Neil,

Not sure I'd ever take a "diagnosis" here at face value. But the info and suggestions I have gotten from medical forums like these have been extremely valuable in helping me evaluate what I've been told by professionals and providing next steps. I always double check anything I read in these forums the available literature. But then again, I do it with my doctors as well!

And the experiences here are invaluabe because like you say we have lived with the consequences of the professionals. Too bad more doctors don't read these forums and find out what happens after their "successful" surgery!  Fact is they are probably too busy getting ready for the next surgery. 

Jim

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Nope. I live in the U.S. Upstate NY. They just started it end of last year. It was voluntary for a couple years. Now they linked all medical records. They even had me sign a paper saying I won't go to other hospitals trying to get drugs. And if I do I can be charged with a crime. I also have to have all scripts sent to the same pharmacy. I don't like it. I think it taints the docs opinions making a second opinion useless. I had a nurse tell me she thought it was wrong. A GP may get complacent and not look as deep as they should. Ignore new symptoms thinking it's all from the same problem instead of digging deeper. A new set of eyes may see something the other doc didn't. I had to travel a hour and a half up north to Syracuse to a specialist for another issue. University hospital. Nothing to do with our local health services( Lourdes and UHS). He had access to all my medical records and had already reviewed them.

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I hate it when docs won't listen to what you have to say. I try to tell them as much info as possible to make there job easier. Some seem to want to draw there own opinion. I think the best docs take the time to listen to you. Then make a diagnosis.

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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.

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..... or picking out their new yacht ...

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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

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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

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That was very interesting.  I wonder if it would be safer not to see a nurse practitiioners and physicion assistants for what is wrong.  Doctor do make the wrong calls sometimes.  All of them were in this test.  Do you get what I'm trying to say.  I have see my family doctor and his nurse practitioner for my throat they still don't know what one.  They both told me diffierent things and gave me different meds.  Maybe we should not trust the assistants.  It hard enough to trust some doctors. But a good practice to start is allway fet a second opinion before you fet any surgery and if the doctor does not like it do it anyway.  That is your right  Take care all  Ken  

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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

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I had a RPA for years. Guy was very good. He left or retired I have no clue. The NP they replaced him with is bad. I get in to see a doc there when I can or just call a specialist as my insurance doesn't require a referral. I have yet to see a NP or assistant who ,in my opinion, seems to know what they are doing. Wish they would just use them for cuts and sniffles. Leave the real doc stuff to docs. Don't like being practiced on.

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Who exactly made you fill out these forums? Was it a hospital? An insurance company? 

I have Medicare with Plan F supplemental. Up until now at least, I could see as many different doctors on the same issue as I want without any records being shared. The only time I've run into the shared record issue is when I see another hosptial affiliated doctor in the same doctor. In this case, sometimes the computers are linked and the second doctor will see my records. But even then, I didn't run into any issues in terms of not being able to get that second opinion.

That said, I haven't been to a doctor this year so maybe this is something new with Medicare? I hope not.

Jim

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Take that back. I think I saw an ENT this year, but maybe late last year. Still, no one made me fill out any papers/releases, etc.

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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