Getting a 2nd opinion from inside the Mayo...is "offensive"?

Posted by conduit @conduit, Tue, Oct 1 6:51pm

My wife was recently diagnosed by a Mayo Clinic surgeon with an 80% failed lumbar fusion requiring complex removal, reconstruction, and extension to her pelvis and up her spine. We would like a second opinion from *another* Mayo surgeon. However, when we inquired about a referral for a second opinion (from the original referring Mayo doctor), ]we were called back by a nurse and passive-aggressively condemned for asking (even telling us she would delete the notes about the request from the patient file so "the doctor wouldn't be offended").

The level of attention she has received for this major surgery pales in comparison to the *minor* surgery she just had at the Mayo Clinic (which was an absolutely superb experience!). The spinal surgeon's office scheduled the surgery and pre-op without even a meeting (beyond the one in which she was diagnosed) to discuss recovery, rehabilitation time (we are planning to rent a local apartment for part of the recovery), expectations, preparations, etc. We don't even know what medications (eg. NSAIDs) she's supposed to stop taking before the surgery.

Is it truly "offensive" to request a second opinion from inside the Mayo because "the Mayo has already directed us to the best choice"? The doctor in question is fresh out of academia and just started there a few months ago, could this be to blame for the unexpected reaction?

Liked by sparklegram

@conduit Surgeons are often stereotyped as being quite egotistical. Probably with good reason. But in my experience a good and ethical surgeon welcomes, even encourages, second opinions. I'm not sure I'd want that kind of extensive surgery done by someone fresh out of med school or fellowship.

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Your wife's surgery sounds extremely complex. The rule of thumb re surgery is try to get a surgeon who has done this type of surgery successfully many many times. Once you have surgery there's no going back as a rheumatologist once said to me. Do not hesitate for a minute, get another opinion.

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@babette

@conduit Surgeons are often stereotyped as being quite egotistical. Probably with good reason. But in my experience a good and ethical surgeon welcomes, even encourages, second opinions. I'm not sure I'd want that kind of extensive surgery done by someone fresh out of med school or fellowship.

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Thank you for the support! In our experience, this kind of reaction would be cause to run far, far away from said medical provider. We continue to believe in the Mayo Clinic, however, based on our previous successes, but now wonder if this is some unspoken rule we've violated. The nurse's assertion is that "many doctors consult on a diagnosis", which I've witnessed firsthand. In this case, however,the doctor in question had never looked at the imaging before the consult and 15 minutes later she was diagnosed. Nobody else was involved.

I guess the real question is, does the Mayo have a formal process / mechanism / office for requesting a second opinion / consult without patients having to worry about being "black balled" by a nurse / doctor with a sensitive ego?

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@conduit

Thank you for the support! In our experience, this kind of reaction would be cause to run far, far away from said medical provider. We continue to believe in the Mayo Clinic, however, based on our previous successes, but now wonder if this is some unspoken rule we've violated. The nurse's assertion is that "many doctors consult on a diagnosis", which I've witnessed firsthand. In this case, however,the doctor in question had never looked at the imaging before the consult and 15 minutes later she was diagnosed. Nobody else was involved.

I guess the real question is, does the Mayo have a formal process / mechanism / office for requesting a second opinion / consult without patients having to worry about being "black balled" by a nurse / doctor with a sensitive ego?

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@conduit, I'm sorry to hear of the experience you've had when requesting a second opinion within Mayo Clinic. You're correct in that Mayo Clinic providers work in teams. It is likely that the recommendations made for your wife did not come from one surgeon alone. However, it is your right to ask for a second consideration or to consult with the team again. It is never "offensive," to gather all possible information and to be comfortable with your team and the treatment choices you make together.

My hunch is that your request for a "second opinion" has been exacerbated by choice of words and miscommunication. I strongly encourage you contact the Office of Patient Experience. You'll find the contact information for all 3 Mayo campuses on this webpage: https://www.mayoclinic.org/about-mayo-clinic/patient-experience

Please call or write to them. This is exactly why the Office of Patient Experience exists. They are there to help.

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I'm not surprised at all with this posting. I had the identical experience at the Cleveland Clinic. I ended up going to the second large medical provider in Cleveland for a second opinion.

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With the PPACA mandate requiring all practitioners maintain electronic medical records for patients, second opinions no longer exists. The loyalty among the brotherhood of doctors is too strong to disagree.

With the large medical providers in cities taking over independent doctors’ practices and the rules and policies that they make the doctors comply with, doctors simply no longer have the freedom to practice
their own opinions else their contracts be terminated.

Two misdiagnosis I’ve had have proven the above to be true. In both experiences a resulting honest follow-up doctor indicated that radiologists are required to list everything they see and resultant what that may be is just like what the pharmaceutical companies do in listing side effects for prescription medicines; they list everything!

Unfortunately, the patient is a victim. In one of my very serious misdiagnosis, I sought a third opinion in yet another medical providers facility, the doctor was not able to electronically bring up the report on his computer (IT could not figure out why) and I ended up simply walking out of the appointment because he refused to request a repeat test at his medical facility. Because of the scare of the diagnosis, I even had the operation, which turned out to be totally unnecessary.

My second misdiagnosis in October (of the year) was made by a “doctor” who had just completed his medical residency in July of that year. I spent additional monies because I kept getting opinions that said “your medical record shows thus and so”, but I had no symptoms of the condition what the “doctor” had said. Incidentally, I went to my doctor, outside of that medical specialty, who indicated what they were reading on the MRI report was something he had been watching for the past ten years and continues to watch to this day.

Good Luck!

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