Patients have Right to Second Opinion

By Dr. Inder Maurya (Founder & CEO, Foreign OPD)

MD – Emergency Medicine, ECFMG Cert. USA, Ex Senior Resident SGPGIMS Lucknow

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, computerization, automation and digitization 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 the 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 & EY, mentioned that 60% of the patients surveyed said that “Hospital 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 one 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 United States, approximately 12 million adult out-patients are misdiagnosed annually. Such situations can be minimized if the patient seeks second opinion.

According to Mayo Clinic’s General Internal Medicine Division in Rochester – 88% 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 family and health, still lot has to be done at the ground level. The problem is compounded by the absence of clear-cut guidelines on the use of the 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 the loved ones, we must know that it is your constitutional right that – Doctors and the hospital 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!

Importance of Second opinion

 The patient can benefit from treatment optimization and avoid unnecessary risks.

 As the Courts are more consumer-friendly now and patients have sued hospitals and doctors malpractice or negligence and the courts have been asking doctors and hospitals to pay for their mistakes, the physician too can benefit from less exposure to legal claims by seeking expert second opinion in diagnostic dilemmas or patient treatment protocols.

 Healthcare Organizations can benefit from increased treatment, quality assurance and costs saving from unnecessary surgery and treatments.

 Private and public insurance companies are trying to control surgery costs by urging and even demanding a second opinion before surgery

 Every patient has the right to seek the second opinion from an appropriate  clinician of patients’ or caregivers’
choice. The hospital management has a duty to respect the patient’s right to second opinion and should provide to
the patient’s caregivers all necessary records and information required for seeking such opinion without any extra
cost or delay

 Any kind discriminatory practice adopted by the hospital or the service providers will be deemed as Human
Rights violation.