
E-Second Opinion — The new kid in the healthcare block
As the term suggests, Second Opinion in healthcare is a practice to seek an additional opinion from a different doctor on a treatment recommended by the primary doctor.
It is a common practice in Kenya these days where patients get a treatment plan by their local doctor and then at times head to another city (probably a bigger metro or Tier II city) to get a Second Opinion. There are situations where the patient also switches treatment to the new doctor — a phenomenon known as ‘Medical Tourism’ (in this case travel within the country).
This can be extended across borders too and patients travel from other countries to India to seek a Second Opinion and even get treated in India.
For a Patient, the key is choosing the right doctor for the Second Opinion. Most often, patients or care takers seek assistance from their friends/contact/family to identify the specialist in a particular field. At other times, the internet seems to be the best bet.
To cater to this mobile segment of the Patient population, Providers (hospitals) have geared up by:
- Setting up satellite clinics in other places (outside their primary location)
- Developing a strong tele-medicine facility in-house and in the target market
- Being more active on the digital front — website, social media
For a Patient, once a doctor is identified, it is important to share all the information with the doctor.
a) A physical meet is preferred since the doctor examines the patient and can provide accurate diagnosis/action steps
b) Given time/distance constraints, especially if it involves travel across countries, the digital route can also be taken. Of late, different digital channels are used for seeking an Opinion — email, whatsapp, phone call — The patient shares photo images of all diagnostic reports, Xrays, photo images of CT/MRI scans etc.
The key though here is — the patient must share all the latest as well as past reports.
The following could serve as a general guide on what a Provider requires for a more comprehensive Second Opinion:
- Complete profile information of the patient — Age, Nationality, Blood Group, Gender, Marital Status, City/Country of Origin etc — These are critical as there could be age/gender/geographic specific background for specific ailments.
- All investigation reports, original CT/MRI/Xray/Angiogram images from the laboratory. (Remember different radiologists interpret the images in different ways, so a report alone may not be totally helpful for the doctor).
- Any physical images of the affected area, a complete assessment of the pain areas that the patient is suffering from.
- Any other indicators — Past surgeries, Hypo/Hyper tension, current medication, allergies etc.
Key elements to look out for when seeking an Opinion are:
a) Ensure the doctor who is giving the feedback has the right expertise and is the specialist of the specific area — this can be done by getting details of the doctor’s degrees/diplomas, his past work and his experience in treating/diagnosing similar cases.
b) Keep in mind that sharing all the relevant information is key as partial information may lead to incorrect diagnosis too.
Case Study
A patient sitting in Nyeri (A small town north of Nairobi) has been suggested a Knee Replacement Surgery by his local doctor. He is unsure of the diagnosis plan and intends to consult a specialist doctor in Nairobi (typical of patients from Nyeri).
He travels to Nairobi and consults a specialist who recommends physiotherapy/medicines for one year before a surgery. Another trip to Nairobi to another specialist lands him in a treatment plan which entails immediate surgery. He is now confused on what next!!! On top of it, he has spent a few days on his travel and close to USD 500 for his two trips to get the two Opinions.
Is e-Second Opinion a viable option for him? Are we geared for this yet?
Would E-Second Opinion be a viable model for especially with the segment of patients who come from overseas to India or even for those in rural India, who don’t have access to expert opinions?
The typical challenges these patients face when coming to opting for an e-Second Opinion are:
- Lack of trust on the mediator (the website/application) to share sensitive medical records about self or the dependent.
- Concerns on the credentials of the doctor, who would provide the e-Second Opinion.
- The lack of facility to go digital to share medical records for the Second Opinion. Or in other words, no internet facility with a computer to upload and share relevant medical records. Even if given an opportunity with a computer, there could be enormous resistance to sit patiently and record all information.
- A preference for a face to face meet with the doctor and not go through a virtual world — computer/internet.
Though there are challenges, the benefits are huge:
- With the e-Second Opinion, he could have narrowed on a doctor and visited the doctor, which would mean, he goes with certain level of preparation on what is expected as a treatment plan, duration of treatment — all in advance. (thereby being able to make a more informed choice)
- From the above scenario, it is obvious that the patient could have saved a good chunk of his USD 500 spend if he were having an option to consult a doctor online.
As part of e-Second Opinion initiatives, we at https://my-healthconnect.com, specialize in connecting patients with providers for a Second Opinion on their medical problem. Our initiatives have been helpful in connecting patients in Kenya to specific doctors in India for an Opinion followed by a treatment too.
