alt Hacker NewsI’m curious: why isn’t a “second opinion” included in the standard medical protocol?
As an engineer, embedding such a check step (basically a PR review for your body!) in the standard workflow feels very natural. But in the medical context, getting a second opinion usually needs extra effort by the patient and often involves awkwardness.
It feels involving too much friction given the high stakes. What is your opinion on this?
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I'm not the poster you're responding to, but I suspect (bitterly) that it's because engineers and architects are held liable if their inattentiveness to detail causes someone to die, whereas medical professionals are not unless they do something so wildly negligent that you could prove it led directly to an already sick patient's death. (And even then). In most engineering scenarios, there's a paper trail leading back to every decision, and what you're working on is a determinstic system with known inputs and expected outputs. In the medical field, it seems as if a second opinion is more akin to getting food at a restaurant and then taking it to another restaurant to ask the chef if it's too salty. The inputs are subjective, the results can't definitely be traced to them, and no one expects anyone to live through the meal anyway.
Good question!
There is a standard practice at cancer centers which would be more the equivalent of PR review. Often it’s called “tumor board” but names vary (ours is called “case conference”). Depending on the institution and department, all, most (anything but the most straightforward), or some (unusual, advanced, prompted by patient discussion, etc.) cases are brought up for a consensus opinion. Like PR review, the format and formality of this process will differ institutionally, but some version of it is standard as part of the “workflow.”
If the specific department reviews all or most cases as a matter of course, it may not even be mentioned to patients (let alone requiring them to ask for it) unless the consensus opinion alters the original plan. Pathology or radiology consensus interpretations if they occur usually precede the issuance of a final report (so as to avoid giving one interpretation that’s potentially acted on but then amended) and are notated with specific verbiage.
A second opinion generally means transferring records and tissue samples outside the original institution. Think of it more like assigning the same bug report to two teams. There is a role for this, but I wouldn’t think of it as PR review.