Life-threatening or not, a serious diagnosis needs a second opinion
After years of heart failure, Marsha Joyce was told she'd eventually need a heart transplant. But that medical advice never really registered with the Lisle mother of three.
Then Joyce asked the lead cardiologist at Mayo Clinic for a second opinion. Joyce and her husband traveled to Minnesota for the appointment, where the doctor delivered familiar advice: Get on the list for a heart transplant.
"It was devastating," Joyce said. "I couldn't believe someone actually said that to me. It really sunk in at that point. This was the cardiologist in charge of Mayo Clinic, so this was the real thing."
The second opinion reinforced the severity of Joyce's condition, and she did get a heart transplant at the University of Chicago Medical Center in 2007.
Patients have a right to a second opinion, which can go a long way to alleviate anxiety about a course of treatment, said Dr. Maria Rosa Costanzo, medical director of the heart failure program with Midwest Heart Specialists and Joyce's doctor at Edward Hospital in Naperville.
Doctors should not be put off by the request to share records and test results -- and some require it.
"If you have the same case reviewed by another physician, you have a new brain and a new approach to a patient's condition," Costanzo said. "Either it makes you think about things you haven't thought about, or it reinforces your opinion."
Costanzo likes to talk to the other doctor to compare thoughts on a patient's care. A specialist in heart failure, she sees patients with advanced heart disease and few options. But often they have more choices than they know.
"Sometimes they haven't been told that they have options, such as a heart transplant or a cardiac assist device," she said.
It's not just life-threatening diagnoses that should prompt a second opinion. Life-altering operations or nonroutine surgeries also merit additional consultations.
Dr. Steven Gitelis, an orthopedic oncologist at Rush University Medical Center in Chicago, requires his patients to get a second opinion before he'll amputate a cancerous arm or leg.
"It's not that I'm not capable of making that decision," Gitelis said. "But it's so drastic. It's a bridge that if you cross it, there ain't no return."
Occasionally Gitelis gets to deliver good news. Sometimes patients walk in who were told elsewhere their only option was to amputate. Gitelis, who specializes in preserving limbs, can save 95 percent of limbs threatened by bone or soft-tissue cancer.
But patients have to take the initiative to look for that expertise.
"I think people nowadays need to be involved in their health care. It facilitates better outcomes," Gitelis said. "In terms of second opinions, any doctor who is against that is wrong."