Virtual second opinions save lives as adoption grows

Sally knew something was wrong, and she felt like her cardiologist wasn’t taking her concerns seriously — even when she passed out. So Sally did something she had never done before and sought a second opinion from a specialist outside of the Denver area, where she lives.

She was able to do so from the comfort of home through an organization that specializes in virtual second opinions (VSOs), providing remote access to expert physicians. Specialists reviewed the results of Sally’s existing tests and concluded she needed a cardiac catheterization. Unfortunately, her local cardiologist “literally ignored the second opinion,” Sally said.

Then, Sally passed out again, identical to the previous episode.

This time, the emergency room took note of the virtual second opinion in her chart, and the cardiac catheterization was performed. Three arteries were blocked: the main artery (the widow maker) was 100% blocked, the next was 70% to 80% blocked and the third was 50% blocked. Nine days later, four stents were installed. Less than a month later, Sally said she was a “new human being.”

As the value of VSOs is becoming clearer, an increasing number of employers are offering second opinions as a health benefit, which can be especially useful for people who are facing decisions about surgeries or major medical procedures. With conditions such as cancer, cardiovascular disease and musculoskeletal disorders accounting for the highest employer health care costs, a second opinion can help ensure employees have the right diagnosis and are on the right track in their health journeys.

Expert review

Second opinions help people make informed decisions that guide their care, and it’s everyone’s right to seek additional counsel about their health. The American Medical Association’s code of ethics requires AMA members to respect a patient’s right to obtain a second opinion, and the American College of Surgeons states: “Consultation has always been a part of good medical practice, and a competent physician should not be insulted if you decide to get further advice.”

The desire to confirm a diagnosis or treatment approach is the most common reason people seek a second opinion. There may be times when an employee may want a second opinion even if the medical attention being provided locally is high-quality care. Maybe there is no improvement after treatment, or they have a rare health condition with minimal local expertise. Regardless of the reason, at least some recommended adjustment to the course of treatment is common, with a recent study finding expert opinions uncover recommended treatment plan modifications in 72% of cases. Once the path forward is confirmed, local doctors are critical to a successful outcome as they continue treating the patient.

Health care specialty deserts and other hurdles

Health care “specialty deserts” are areas of the country that do not have adequate health care infrastructure. Access might be limited to medications, primary care providers, hospitals, emergency services and community health centers — or even internet access and basic health literacy. Today more than one-third of Americans live in a county that meets the definition of a health care desert. It’s a situation that is likely to become worse as 100,000 physicians leave the medical profession by 2025. VSOs can be a key part of the solution to bridge the gap in specialty care access.

There’s also the matter of time and travel expense. Even when specialty expertise is available locally, getting an appointment with a specialist often can take weeks or even months. Gathering the necessary medical records can be complicated and time consuming. Many people are uncertain where to find an appropriate specialist for their case, or they find it challenging to travel long distances for in-person consultations — the sort of commitment that doesn’t just demand time from the patient, but also the costs of travel, lodging, potential lost wages and more.

Telemedicine took off as a replacement and complement for in-person physician consultations during the pandemic, and VSOs are taking that care to another level with access to the top specialists in the country to guide treatment.

The virtual second opinion process

Virtual second opinions enable employees to receive medical advice on complex conditions anywhere in the world. The best VSO programs have a few characteristics in common — with specialists in many different diseases and conditions, ranging from cancer and cardiology to digestive diseases and musculoskeletal disorders to even the rarest of conditions — for both adults and children. These VSOs relieve patients of the complex and time-consuming efforts required to gather medical records, often from multiple offices, imaging clinics, and other providers.

Related: Virtual care can address rising costs of worker GI health

It’s one-stop access to the surgeons, oncologists and other subspecialists that may be required across the entire spectrum of care. This can greatly reduce the hassles of scheduling multiple in-person appointments with multiple providers.

Empowering people in their health journeys

VSOs provide access to the highest quality, expert coordinated care available. They also provide peace of mind to people who have been diagnosed with a serious condition, are about to make a major decision about a medical next step, or have questions about their existing treatment plan. In Sally’s case, a virtual second opinion provided an opportunity to get the care she needed and get back to living her best life.

Nancy Papesh, RN, BSN, MBA is the Director of Clinical Operations at The Clinic by Cleveland Clinic, which specializes in Virtual Second Opinions with access to 3,500 world-renowned Cleveland Clinic specialists.