Tutorial

Second Opinion & Conference

Although medical knowledge is universal, its interpretation is personalized. When the level of scientific evidence is low or the disease is rare, a second opinion or medical conference could be useful as a mean to increase accuracy in the decision making-process. When browsing through the items below, you will better understand how physicians interact in a second opinion or medical conference and how patients could benefit from these resources.

  • Anytime, the patient fills unsecure with the diagnosis or physician’s recommendation, the second-opinion is advisable. Sometimes, also the physician suggests a second-opinion, especially in rare diseases or unpredictable disease’s outcome. In these cases, the second opinion would be useful both for the patient and the physician. The second opinion is not the rule, but when needed is an intelligent decision toward a better clinical result.

  • When cancer is diagnosed, the patient usually is under great emotional impact. All the efforts should be done to comfort the patient, orienting him toward a stable and rational decision process. Patient stability depends on the acceptance of the diagnosis, which should be supported by a good doctor-patient relationship. In case of difficulty in either of these circumstances, a second opinion could be helpful. The patient will have the opportunity to double-check his diagnosis and expectations under another professional critical view. Under patient discretion, it would be desirable the medical professionals exchange views on his clinical case. It would be a mature attitude, searching consensus, which would create a safety environment for the patient’s decisions. There is no ethical mistake in searching for a second opinion.

  • Despite the medical recommendations being based on international specialized journals and supported by levels of evidence, the decision process in each clinical case is always individualized. The doctor critically assesses the medical knowledge and makes a recommendation. The patient may express a desire to listen another opinion. Physicians should encourage the second opinion, strengthening the sharing decision process. A second opinion should not be understood as a dispute between two medical professionals. Rather, they should join efforts for better help the patient.

  • Medical conference is a situation in which two or more doctors of complementary specialties discuss the patient's case. The medical conference may be requested by the patient or suggested by the doctor. The patient should authorize the participation of all professionals involved in the medical conference. This is a delicate situation from an ethical point of view, since all the clinical data belongs to the patient. Therefore, only the patient could release the assessment to its clinical data. When the patient is unable to do so because it is unconscious or with cognitive neurological problems, this right should be exercised by the family. Since, the patient has approved medical conference, doctors can exchange information on all his or her clinical data. Doctors may also discuss combined treatment interventions. As far as possible, a consensus should be pursued. The patient is encouraged to be examined by all physicians who participate in the decision process. All information is recorded in a report signed by all physicians participating in the medical conference.

  • There are some situations asking for urgent decision-making, which does not allow enough time for sequential interdisciplinary assessments. The medical conference convenes multiple professionals with complementary skills, streamlining decision-making and sharing critical insights. Both doctors and patients, benefit from this timesaving process.