Patient Advocate: Should you get a virtual second opinion for your health diagnosis?
If you receive a diagnosis that will require a major intervention, such as hospitalization, chemotherapy or surgery, consider getting a second opinion. Why? Because medicine is almost as much art as science, and two heads are usually better than one.
These days, you have more options for accessing second opinions. Virtual second opinions have been growing in availability and use over the last few years, fueled partly by the pandemic and partly by shortages of medical specialists in many areas of the country. In fact, they’ve even got their own acronym: VSO.
What is a virtual second opinion?
A virtual second opinion allows you to consult with a medical specialist who could be in another state or even another country. Specialists can review your records, images and test results and report whether they agree with your diagnosis and treatment plan.
You would turn to a virtual second opinion for the same reasons you’d seek a traditional one. VeryWell Health, a partner of Cleveland Clinic, offers these considerations:
• If you’ve undergone treatment and your symptoms persist.
• If treatment will require surgery or long-term therapy, or will have a lifelong impact on your quality of life.
• If you are diagnosed with cancer, which is a complicated disease with many treatment options.
• If you are diagnosed with a rare disorder. In particular, research doctors who have treated your disorder.
• If your instinct tells you something is “off.” This is particularly true when you’re trying to get a diagnosis for your child.
Medicare covers second opinions, including the virtual kind, as long as your doctor has recommended surgery or another major diagnostic or therapeutic procedure. Medicare Advantage policies usually follow suit, but be sure to confirm with your particular company.
If you’re unsure about whether you need a second opinion, a medically trained patient advocate can help you review your options.
How to find a virtual second opinion
You can start with Dr. Google, Dr. Safari, Dr. Bing or your own doctor, but be sure to select a trustworthy provider, such as a major medical center like the Mayo Clinic or accredited medical school.
For example, the University of Chicago School of Medicine offers VSOs through a secure platform. After you sign up, a coordinator will be in touch to gather your records, and you will receive a written report.
You can access a VSO from anywhere, which is a great benefit to people who don’t live near major medical centers or are in underserved rural areas. While you may need an internet connection, video conferencing is usually optional.
If you have to pay out-of-pocket, a VSO typically costs between $700 and $2,000. Charges can be higher if the review is particularly complex or a pathology review is included. There are cheaper options, but I would be wary of them.
Possible outcomes
Your second opinion may reassure you that your current diagnosis and treatment are appropriate. It’s also possible that even if the current diagnosis is correct, changes in the treatment plan may be recommended.
The second opinion might also disagree with your diagnosis and treatment. This was a surprising result when doctors looked at the virtual second opinions that 657 cancer patients received from Stanford University’s School of Medicine between 2018 and 2020. The VSOs recommended a treatment change in 53.8% of the cases, a much higher percentage than with traditional second opinions.
More study is needed to determine why this happened, but the researchers also noted that VSO may help address the worldwide shortage of cancer specialists.
A big question about VSO
An important issue for doctors issuing virtual second opinions is whether they need to be licensed in the state where they are delivering their opinions. Technically, the answer is yes: They are providing diagnostic recommendations that may affect the course of a patient’s treatment.
An offense like that could cost doctors their license.
There’s a workaround, however: Doctors are allowed to provide virtual second opinions on a peer-to-peer basis. In other words, your doctor is allowed to consult with a doctor in another state. Because of this, I recommend that, if you’re looking for a VSO from an out-of-state provider, you should work with your doctor to obtain it.
In a 2021 study, the Mayo Clinic found that a second opinion cuts the chance of misdiagnosis in half, yet it’s estimated that only 5% to 10% of patients seek them. If you have any concerns about your diagnosis or treatment, get a second opinion — in person or virtual.
• Teri (Dreher) Frykenberg, a registered nurse, board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” available on Amazon. Frykenberg offers a free phone consultation to readers. Contact her at Teri@NurseAdvocateEntrepreneur.com.