Forum: Downsides to seeking a second opinion

In his Opinion piece, Associate Professor Devanand Anantham stated the advantages of seeking a second opinion from another doctor (Is it worth asking another doctor for a second opinion?, May 25).

But patients ought to be aware of the downsides of seeking a second opinion.

First, incomplete evaluation may lead to wrong diagnosis or treatment. For instance, some patients would e-mail me their laboratory and MRI reports and request a diagnosis and treatment plan.

Without evaluating the patient in person, going through all the laboratory reports and imaging studies, and understanding their concerns, it is unsafe to give any specific medical opinion.

Second, the second doctor would often ask for more investigations like image-guided biopsies and diagnostic endoscopies. This will lead to additional costs, risks, and delays in treatment.

Last, clinical studies have shown that the second doctor disagreed with the first doctor in diagnosis or management approach in approximately half of the cases. This may confuse the patients.

Some patients would even go on to seek a third opinion from another doctor, who may not agree with either of the first two opinions.

Patients should not routinely ask for a second opinion for all their medical issues.

I advise patients to seek a second opinion if they disagree with the approach and management plan of their doctor, or if their medical problems are complex.

Patients may not be any wiser after seeing more doctors if none of the doctors agrees on a consensus diagnosis or treatment.

Desmond Wai (Dr)