In my altruistic medical practice, I`m often called upon called upon to give a second opinion on the management of all kinds of illnesses. This usually originates in friends and family, from all parts of the world. Though it does not give me any materialistic benefits, it does help me understand medical practice around the world, doctor and patient perspectives and most importantly people`s behaviours and attitudes. My `clientele` is usually well to do, educated, accomplished and sometimes well researched. Some are doubters, some have specific questions, some are pressurised by their peers and some do it as a prop before taking a final decision. I usually feel quite honoured and important and try to do a good job. Especially because some of the professionals I have looked up to and it is sometimes a unique opportunity to get into their minds. Since this process takes place online and over the telephone, this gives a unique opportunity of what health in the digital age would look like.
More often than not, I marvel at the pains that the doctor has taken to investigate and formulate a management plan and it is just a matter of reiterating something that someone has already said and explaining in a way that the client is most comfortable with. This is completely understandable because most patients due to anxiety or otherwise do not actually follow in details what the doctor is saying and it usually takes a more familiar professional (usually the General Practitioner) to explain what the consultation was about. Some are in shock and disbelief and though they do understand the gist, but fail to understand the right questions and thus need to be spoken to with a lot of tact. Though it is imperative that the client is taken into confidence, it does happen that a certain adverse report may set the client back and a lot of social factors do come into play and the mind begins to wander during the consultation resulting in lack of effective communication. I have no answers as to what is the best solution to this because as a doctor I have probably been guilty of my client not fully comprehending what the management essentially entailed, but I`ve always been blessed with an army of extremely skilled specialist nurses and a multidisciplinary team who have worked tirelessly behind the scenes and clients have been completely up to speed in the next consultation. Whether they have sought a second opinion or not is anybody`s guess.
The real test comes in the case of a conflict, when the client is completely dissatisfied with the opinion or outcome of a consultation. This scenario has multiple possibilities. One, when I am disagreeing with what the written and verbal communication from the client is. There are multiple ways of tackling this. The first approach is to try to gauge what was in the mind of the practitioner and what information and resources did the practitioner have both medically and socially before giving his opinion? What the local and accepted practice is? Whether the cause of the conflict is due to a certain bias of the client? The opinion needs to be balanced and mature taking into consideration multiple angles and proper reasoning for your views must be given. The best option (if possible) is to speak to the practitioner. Usually doctors are happy to speak to a fellow practitioner as then more scientific evidence can be discussed. In some cases of disagreement, I have found that though the opinion was scientifically correct, there has been some misunderstanding or there were some family or social issues that the doctor at the time was not aware of.
Though clients are a bit wary of reprisal from the doctor for seeking a second opinion. This is something normal and must not be discouraged. In fact, in most instances it gives credibility to a practitioner and his opinions. The contentious question of course is retention of clients. This an extremely delicate issue. The choice of a practitioner depends on multiple factors many of which are subjective. Sometimes it is difficult to comprehend why a client chooses a certain professional over other. But by no means that a second opinion should be denied to anyone.
Digital health has the propensity to facilitate a harmonious environment where clients can seek opinions transcending geographic barriers, discuss with people in similar situations, read and converse about people with similar experiences. Professionals on the other hand are able to seek advice, confer with other professionals and gauge the mood and opinions of clients in order to improve their practice and do their best for clients which is the ultimate goal.