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          Getting a second medical opinion

          When my friend called me about his father, who had passed out, I learned that the cardiologist had done an EKG, pronounced the elder gentleman "fine,"? and sent him home.

          "How is he feeling?"? I asked.

          "Too weak to get up out of his chair,"? my friend said.

          Getting a second medical opinion Second opinions should be easy to obtain. Photo courtesy of Truthout.org/Flickr

          "Hang up the phone and dial 9-1-1,"? I said. "Call me from the emergency room and I'll talk to the doctor in the ER."?

          An hour later I was on the phone with the emergency physician. "He's having six-second pauses on his rhythm strip," said the ER doc, meaning his heart was stopping. "He may need a pacemaker. We are going to admit him to the hospital."?

          "Why didn't the cardiologist diagnose this?"? my friend asked.

          "Because your dad wasn't having the pauses in his office. It's like the car that stops making the noise when you bring it to the mechanic."?

          Second medical opinions often are of value. Unfortunately they are complicated by a multitude of issues. Physicians may feel you don't trust them, or be insulted by the request. If the second opinion contradicts the first, do you go for a third, a fourth, or a fifth opinion? This all costs (someone) money. Some insurers require (and pay for) a second opinion prior to expensive procedures. Others may refuse to pay for one at all. Each opinion requires a separate appointment, takes time, and can delay treatment.

          Over the years I have helped my friends and family make difficult decisions, save many thousands of dollars in medical bills, and perhaps even prevent a bad outcome or two. Wouldn't it be nice to have a doctor in the family whom you could call for a quick second opinion, or to help you decide what to do next?

          One of the motivations for starting First Stop Health is to make this type of "doctor in the family"? service widely available--be it through patient advocacy, better telemedicine services, or helping connect people directly with physicians for second opinions.

          Mark L. Friedman MD FACEP FACP is an emergency physician working to revolutionize the delivery of health care.