Multiple consultations versus medical shopping

NK Sethi, MD

Assistant Professor of Neurology

NYP-Weill Cornell Medical Center

New York, NY 10021

I recently read an article in New York Times titled “The story behind Kennedy’s Surgery” by Lawrence K. Altman in which he discusses the decision making process which led to Senator Kennedy undergoing brain surgery for his malignant brain tumor at Duke University. As per the article a few days after Senator Kennedy learned he had a malignant brain tumor in the left parietal lobe, he invited a group of national experts to discuss his case.  These experts were leaders in their field and came from different academic centers of excellence. I assume they included neurosurgeons, neurooncologists and other specialists in radiotherapy and oncology. Senator Kennedy’s case was discussed and the best plan of therapy decided on “by all”. While it is easy for a man of Senator Kennedy’s stature (he is the chairman of the Senate’s health committee) to summon all these experts, can a common man achieve this level of care.

Well yes and no and this brings me to what I wanted to discuss, the benefits of multiple consultations versus the risks of medical shopping. While most of us do not have the ability to assemble experts across multiple specialities under one roof to discuss our case, we all can and should seek a second opinion when confronted by a vexing medical issue. This is especially true when either the diagnosis itself is in doubt or when there are multiple approaches to treatment like for example in Senator Kennedy’s case where the issue was whether the tumor should be operated and surgically excised versus should he opt for radiation and chemotherapy. In a case like that I would surely recommend getting a second opinion and multiple consultations if need be, one from a neurosurgeon, another from a neurooncologist and a third from a specialist in radiation oncology.

There though is a fine line between seeking multiple consultations versus ending up medical/ doctor shopping. How should one go about getting these multiple consultations? One way would be to let your doctor act as the “middleman”. Go via him and not try to bypass him. Most physicians do not mind if their patients request a second opinion especially when confronted with a difficult case.Yes to an extent it is a blow to our ego that our opinion is been questioned but in the end most physicians do not mind. Your physician shall make sure you navigate the maze of second opinions successfully and gain the most out of it. From referring you to the right person to making sure you carry all your relevant medical information when you go and seek the second opinion. He or she may also in the end help you decide on the best course of action. Else it is easy to fall into the trap of medical/ doctor shopping. Looking around till you find a doctor who tells you what you want to hear!!!