Second opinion helps patients avoid “unnecessary” surgery

Sunday, January 25, 2015

Mumbai: Kandivali resident Gaurav Sharma’s uncle was advised cardiac surgery as he was having severe pain in his left shoulder. The surgery was about to happen the next day itself. He logged on to, which offers medical second opinion services, and sought a second opinion from a cardiac surgeon in Delhi who then went ahead and informed the patient that he only had an orthopaedic problem. Sharma then sought a second opinion from an orthopaedic surgeon in the US, who diagnosed it to be a shoulder problem and recommended some exercises to provide him relief. Sharma’s uncle avoided a surgery and his shoulder pain has reportedly reduced significantly.

In another similar instance, a patient from Patiala, who was suffering from urinary incontinence and recurrent urinary tract infection, sought a second opinion from a US based paediatric urologist, who then advised him certain medications which relieved him from his “dribbling urine” problem.

MediAngels recently studied its first 20,000 consultations over the past two years. About 12,500 of the 20,000 patients sought opinions on surgery related cases — i.e. they had been suggested surgery and wanted to know if this was the only or the best choice for their health.

Of the 12,500 patients who sought surgery related second opinions, the second opinion provided in 44 per cent of these patients suggested the surgery was unnecessary and there were more relevant, less invasive, treatment options available.

“Unnecessary surgery is not new in medicine. Orthopaedic surgeons in the United States were, four months ago, accused of overdoing total knee replacement surgeries by almost a third. Closer home, doctors in Andhra Pradesh rampantly performed hysterectomies in 2010 to get a higher payoff from government medical insurance schemes,” said a statement by MediAngels.

MediAngels claims to have 350 “by invitation only” doctors from over 93 specialties and over 15 countries, as part of its physician network.

According to MediAngels, 70 per cent of its users were from the top 10 cities of India; 5 per cent were from the countries other than India — US, UK, Middle East and Africa being important geographies. Also, 22 per cent patients were referred by their treating physicians or a physician they knew.

“While evidence-based clinical practice guidelines and preferred practice protocols exist in a variety of specialties and subspecialties in medicine, consistent evidence suggests that adherence to guidelines may still remain poor. This data justifies the very reason why patients and doctors are increasingly seeking second opinions and online consults,” the statement said.

Dr Debraj Shome, a facial plastic surgeon and co-founder and CEO of MediAngels, who started MediAngels, post a personal health experience, said, “The best medical outcomes occur when you receive a diagnosis and treatment on your disease from a physician who has the most training and expertise in treating that disease. However, these super-specialist doctors are very rare resources. And, one of the major problems is equitably distributing these specialist doctors all over the world.”

He further said, “Our data shows that maybe getting to the right doctor could make sure that these patients would have received the appropriate advice regarding their disease. As medicine becomes more and more super-specialised, medical outcomes improve. Another thing to remember is that doctors too come from the rest of society. If other professionals are making commercial decisions, doctors too are humans and some of us may do that. Hence, to protect your interests, it is always good for patients to seek a neutral, credible, second opinion. We even look at a second store, before buying a phone, why should our health then be any different?”

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Comment by kaleem mohd
2016-04-07 13:46:38

The second opinion has a valuable place in ensuring the most optimal outcomes for both the patient as well as the society as a whole. However, promoting the practice of second-opinion by demonizing the medical community and by creating a false fear in patient’s mind is equally unethical as may be conducting an unnecessary surgery. for more info:

Comment by anuj
2017-05-08 13:35:38

Second opinions are fairly routine. They bring peace of mind and encourage patient engagement.

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