Don’t Be Afraid to Get a Second Opinion: DMC Solutions

By Sadaf Siddiqui, Director, Legal and Compliance, DMC Solutions™

August, 2009 – Facing a serious illness can be nothing short of overwhelming. Imagine being told by your doctor that you have been diagnosed with a critical medical illness. The diagnostic scenario usually plays out like this:

  • You are told that you have cancer/AIDS/Alzheimer’s/multiple sclerosis/etc.
  • You become numb with fear.
  • Your Doctor recommends a treatment plan.
  • Your Doctor refers you to a specialist he/she trusts (or one that is available to take on new patients).
  • You follow your doctor’s orders and start the prescribed treatment.

But how do you know you are getting the most effective treatment for your illness? How can you even be sure your illness has been diagnosed correctly?

Patients can certainly Google for more information on their illness, and many do, but where can they go if the information they get online raises even more questions?

A report published by the Canadian Medical Association Journal concluded that:

  • as many as 24,000 patients die each year due to “adverse events” caused by health care management rather than the patient’s underlying condition;
  • 87,500 patients annually in Canadian acute care hospitals experience an adverse event;
  • 1 in 13 adult patients in a Canadian hospital encounter an adverse event;
  • 1 in 19 adults will potentially be given the wrong medication or wrong medication dosage;
  • 37% of adverse events are “highly” preventable; and
  • 24% of preventable adverse events are related to medication error.

The Canadian Institute for Health Information reports that nearly one quarter of Canadian adults (5.2 million people) had experienced a “preventable adverse event” , either themselves or with a member of their family.

Considering recent news of multiple, very serious misdiagnoses in several provinces, these statistics should come as no surprise.

For example, a recent study published in the November 18, 2008 issue of the Canadian Medical Association Journal concluded that as many as one-third of asthma patients age 16 and over may not actually have the chronic disease. The dangers of misdiagnosing a patient’s true condition are obvious. “The commonest medicines that we use are inhaled steroids,” says Dr. Shawn Aaron, the study’s lead author and head of respiratory medicine at the University of Ottawa. “They are safe for patients with asthma, but are associated with long-term side effects, including osteoporosis, glaucoma and cataracts.”

Another recent study presented at the American Stroke Association’s International Stroke Conference 2009 found that there is often a misdiagnosis of younger adults who arrive at hospital emergency rooms after suffering a stroke. As part of the study, researchers focused on how medical teams handled 57 stroke patients ages 16 to 50. Fourteen per cent were misdiagnosed and discharged from hospital, with a later discovery that they had suffered a stroke, including:

  • An 18 year old who reported numbness on his left side but was diagnosed with alcohol intoxication;
  • A 37 year old who reported difficulty speaking and was diagnosed with a seizure; and
  • A 48 year old with sudden blurred vision, an off balance walk, lack of muscle coordination, difficulty speaking and weakness in her left hand, who was told she had an inner ear disorder

Dr. Seemant Chaturvedi, a senior author of the study, stressed the importance of early stroke diagnosis in improving stroke outcome and preventing permanent disability and paralysis.

Aside from studies, such as the ones cited above concerning widespread misdiagnoses, there are numerous, individual cases such as:

  • The 41 year old Quebec woman who was misdiagnosed with a fatal form of cancer. After three months of prescribed chemotherapy, it was discovered that the alleged cancerous tissues were actually a series of brain aneurysms.
  • The case of a Windsor, Ontario woman, who was repeatedly misdiagnosed in Ontario and told there was nothing wrong with her despite having a report from Henry Ford Health Centre in Detroit, Michigan, showing she had cancer. She ultimately received a successful course of treatment from that U.S. hospital.
  • And the unfortunate story of another Windsor area resident, whose doctors were unable to definitively diagnose her and told her she probably had multiple sclerosis or maybe lymphoma. When her symptoms worsened, no beds were available in her local hospital, so she turned to the Henry Ford Health Centre in Detroit. After two MRIs and a biopsy within 24 hours, she was diagnosed with a primary advanced cerebral lymphoma. She started chemotherapy in Detroit right away, but it was too late and she died two weeks later.

    And then, of course, there are the cases that we know of from unfortunate personal experiences or ones we hear about through friends, coworkers and acquaintances.

    It’s time that we recognize that medicine is not always an exact science and doctors are not infallible. As patients, we need to be more proactive and better informed in making critical decisions about our health. What can you do?

  • Research, investigate, Google. Find out as much as you can about your diagnosed illness. What are your symptoms? Do your symptoms match your diagnosis or is your diagnosis based purely on a lab test? Keep in mind that labs can make mistakes too, so ask about a re-test. Are there other tests or treatments available for your illness? The internet is a valuable resource, but everything you read on the internet may not be entirely accurate either.
  • Ask your doctor for a referral for a second opinion, recognizing that this may take some time due to possible doctor shortages and specialist waiting lists. Under government health insurance plans, you are entitled to a second opinion and most physicians should be receptive to you asking for one. Even if your doctor isn’t that warm to the idea of a second opinion, firmly request one. Remember, this is your health at risk.
  • Obtain a second opinion through a recognized medical second opinion provider.
    • Particularly where time is of the essence and you cannot wait for your turn to come up on another wait-list, a medical second opinion service may save you valuable time in getting a diagnosis from leading specialists in the field. Some medical second opinion services allow their members to have their diagnosis and proposed treatment plan evaluated by top disease-specific specialists from medical centres around the world, without any need for them to travel. By giving you access to an independent review from a leading medical centre, this service provides you and your physician with comprehensive information and advice to help you make important decisions about your health.
    • You will have access to top disease-specific specialists to review, not only your diagnosis, but also the proposed treatment plan and provide their feedback on whether it is the best care you can be getting for that particular disease. Given that some research has shown that a medical second opinion can dramatically change a proposed treatment plan in as many as 30% of cases, a second opinion can be key to getting the best treatment available – which is especially important when faced with a potentially life threatening situation.
    • Once you have the information you need to make critical treatment decisions, you can at least have peace of mind that you are receiving the best care and treatment for your illness, and you can focus on getting better.

For more information on these services please visit DMC Solutions™ at www.dmc.ca. DMC Solutions™ is a third party administrator of niche insurance, warranty and inclusive credit card programs and also provide, manage and administer niche products and services to the customers, members and employees of financial services companies, credit card issuers, affinity groups, insurance companies and employers. or how you can receive the benefits of Card and Information Registry, Identity Theft Insurance or Identity Theft Restoration, contact Jean Hervieux at DMC Solutions at jhervieux@dmc.ca or (905)305-4251.