Study: First medical opinion can affect the second opinion

Health Scan: Clalit offers to send a daily SMS to the cellphones of members who want reminders to take their medications.

Pills 311 (photo credit: Courtesy)
Pills 311
(photo credit: Courtesy)
Israelis are increasingly taking advantage of the right to ask for a second medical opinion, now that this is subsidized by their health funds’ supplementary health insurances. A new Ben-Gurion University of the Negev study – claimed to be the first of its kind in the world – shows that physicians who give second opinions are influenced by external factors. Dr. Geva Waschitz, Dr. Nadav Davidovich and Prof. Yosef Pliskin and other researchers at Soroka University Medical Center in Beersheba recommend that patients seek an alternate opinion when they hesitate to take the advice of their own physician.
The aim of the study was to determine whether doctors who give second opinions are influenced by the first opinion.
The researchers presented a hypothetical case to a national sample of orthopedists.
Some of those queried were told that the patients had previously received diagnoses and recommendations, but were not told what they were. Others were told what the first opinion was. The rest were informed that after they gave their second opinion, the patient was interested in hearing an additional opinion from another doctor. When the orthopedists knew that the first doctor had recommended surgery, they were more likely to recommend an operation as well, and when they heard the patient was looking for yet another opinion, the orthopedists were much more likely to recommend conservative treatment such as physiotherapy instead.
Personal interviews with 35 neurologists and orthopedic specialists found that they generally had a positive view of second opinions, and even encouraged patients to seek them. But second opinions also involve difficulties in patient-doctor relationships, and among specialists themselves. It is also difficult for patients to choose what to do after several doctors offer conflicting advice.
Specialists interviewed also noted the tension between public and private medicine, the gaps in accessibility between patients in the center and those in the periphery of the country, family intervention, and the legal and economic aspects of second opinions.
Are you a member of Clalit Health Services who tends to forget to take your medications? Now the largest health fund offers a free service: it sends a daily SMS to the cellphones of members who want it while protecting patients’ privacy. It says that those who forget to take their pills include young people who are too busy with daily life and the elderly with chronic illness whose memory is deficient. Dr. Yossi Bahagon, head of online services at Clalit, says most people who take medications on a daily basis are aged 45 to 65. Research in Israel and abroad has found that about 60% of them don’t take their pills regularly, and forgetfulness is one of the main reasons.
The customer can choose his preferred SMS message, and the frequency of taking the drug recommended by his physician.
Parents of children with type 1 diabetes can register to remind them when to take insulin, while adult children can register their ageing parents. The service is applicable to all cellphone models that use SMS service.