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Right to Second Opinion

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Dr Inder Maurya, Founder and CEO, Foreign OPD highlights why second opinion is not just a good idea, often it is essential and can make a difference between life and death

Healthcare in India is not what it used to be two decades ago. Nearly every aspect of it has gone through paradigm shifts. And for the better! Hospitals have become much advanced in terms of infrastructure and technology. More physicians have advanced training than ever before. Complex branches of medicines such as organ transplant, cancer, heart diseases are empowered by global research and solution driven diagnosis by powerful sets of skilled physicians and world-class infrastructure. Having said, computerisation, automation and digitisation have not only enhanced the consumer experience but also improved clinical outcomes.

While the industry is moving up in bell curve, there are systemic gaps – often significant ones. One such is ‘second opinion’. In a nut shell – Second opinion is a decision-support tool for ratification or modification of a suggested treatment, by another physician. It represents a novel advancement in modern healthcare services. As healthcare delivery shifts to a patient-controlled model of care, expert second opinion is poised to lead that transition, preventing diagnostic errors, saving cost and avoiding wrong treatments which can have lethal consequences. Many diseases are inherently complex and there are no clear answers either in terms of exact diagnosis or the best course of intervention. In certain cases the physician responsible for the patient’s care might lack the much needed expertise. The problem can be further magnified with misplaced egos and a revenue driven approach that hospitals resort to (A recent report jointly conducted by FICCI and EY, mentioned that 60 per cent of the patients surveyed said that “Hospitals don’t act in our best interest”). Finally it could simply be the lack of time or fatigue that might lead to incorrect diagnosis. After all, at 1:1200, the doctor patient ratio in India is very low as compared to the countries with advanced healthcare (1:300 in USA). The outcome can be disastrous to patients.

Second opinion is therefore not just a good idea, often it is essential and can make a difference between life and death. If our loved ones has been diagnosed with a serious disease and are provided various preoperative and postoperative treatment options, expert second opinion can assist us in navigating through the confusing and expensive medical treatment process.

Common areas where second opinion mostly sought are in the field of cancer, organ transplant, cardiovascular, neurological illness , pre- surgical advise etc.

Globally the situation is similar. In the US, approximately 12 million adult out-patients are misdiagnosed annually. Such situations can be minimised if the patient seeks second opinion. According to Mayo Clinic’s General Internal Medicine Division in Rochester- 88 per cent patients looking for a second opinion would leave the office with a new or refined diagnosis, whereas 1/5 of the patients they saw was incorrectly diagnosed. A significant factor playing an irritant role today, is also the availability of information online and the patient’s tendency to seek and trust such opinion. With disastrous consequences at times. To prevent such inappropriate treatment, it is both in the patient’s and the doctor’s interest to encourage second opinion from a competent fellow professional. Although the Government of India, has been supportive in healthcare through its social scheme like Ayushman Bharat and making second opinion as the patient’s right one among the 17 charter rights of patients published by Ministry of Health and Family Welfare, still a lot has to be done at the ground level. The problem is compounded by the absence of clear-cut guidelines on the use of second opinion. In India, our medical councils have failed to contribute to the discussion, or to regulate the use of the second opinion in any way. Having said, as patients or loved ones, we must know that it is your constitutional right that – Doctors and the hospitals must respect your decision if you choose to seek a second opinion from a doctor/hospital of your choice. And in case you choose to come back to the first hospital after getting your second opinion, the hospital still cannot compromise on the quality of healthcare services. So, go ahead and claim your right to the right treatment!

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