Your primary care provider has just diagnosed you with a serious illness, one that could potentially change your life. Should you accept this diagnosis? Or should you seek a second opinion from another specialist?
For a patient diagnosed with a serious or life-threatening illness or the need for surgery, a second opinion could have a major impact on the prognosis and treatment — especially in light of new research that compared the accuracy of initial diagnoses by primary care providers with follow-up diagnoses by specialists.
In a study of patients seeking second opinions from the Mayo Clinic, researchers found that only 12 percent were correctly diagnosed by their primary care providers. More than 20 percent had been misdiagnosed, while 66 percent required some changes to their initial diagnoses.
The 286 patients in the study ranged in age from 15 to 80-plus, with 64 percent younger than 64. Their cases were evaluated by a Mayo Clinic internal medicine group that specializes in uncertain diagnoses. The diagnoses were based on face-to-face meetings between physicians and patients, as well as a review of medical records, the study noted.
“Knowing that more than one out of every five referral patients may be completely [and] incorrectly diagnosed is troubling — not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all,” said lead author James Naessens, a Mayo Clinic health care policy researcher, in a statement.
Previous studies have shown diagnostic errors contribute to about 10 percent of patient deaths and “6 to 17 percent of adverse events in hospitals,” the researchers wrote. A 2015 study by the National Academies of Sciences noted that an estimated 12 million Americans, or about 5 percent, who seek outpatient care experience diagnostic errors.
“Diagnosis is extremely hard,” Mark L. Graber, a senior fellow at the research institute RTI International and the founder of the Society to Improve Diagnosis in Medicine, told the Washington Post. “There are 10,000 diseases and only 200 to 300 symptoms.” Graber was not involved in the Mayo Clinic study, which was published in the Journal of Evaluation in Clinical Practice.
Not all patients require second opinions, but referring them to specialists to confirm the diagnoses can protect the patients’ health and result in cost savings, the researchers wrote. Unfortunately, some health insurers — in order to hold down costs — won’t cover second opinions from experts outside their networks.
“A potential unintended consequence of [this] limited access is misdiagnosed resulting in treatment delays, complications leading to more costly treatments and even patient harm or death,” the authors said.
Or, as Graber told the Post, “If you are given a serious diagnosis, or you’re not responding the way you should [to medication], a second opinion is a very good idea. Fresh eyes catch mistakes.”