Tuesday, February 09, 2010

2nd opinion

when we go shopping for, say, an electrical appliance, it's customary to go to a few shops & enquire about the price, free gifts, delivery date, after-sales service, etc. because naturally we want the best deal. or, to put it in another way, we desire more for less. that's understandable.

it's the same with doctors. if you are not particularly familiar with any physician, you'll probably go from one clinic to another to get the best price for the treatment, the most patient & understanding doctor whose clinic nurses are the most polite & the medical centre with convenient & preferably free parking. that's perfectly understandable, too.

sometimes there is a twist. let's say you have chosen your doctor & has been receiving treatment in hospital. after some time, you think, whether correctly or not, that you're not getting the right treatment. then you ask for a 2nd opinion, which is absolutely within your right. as it turns out, this 2nd doctor is much younger, less experienced but certainly more energetic with lots of new ideas.

unfortunately, his treatment runs counter to the 1st doctor's.

sometimes patients put us in a difficult position, although they don't realise it. there's no right or wrong answer to this predicament because medicine is not an exact science & many grey areas exist. what are the 2 doctors to do? more importantly, how will this arrangement benefit & not disadvantage the patient?

again, i fear there are no right or wrong answers


Unknown said...

Yap, sometimes we are confused too........

I remembered when we were trying for the second baby, one doc said that we could never had the second one due to dont know what,,, but then after 4 years we had one,, then he called that a miracle baby, hahahahh,,,,,,,,,

ilene said...

Whilst I sympathise with the doctors, but who's to sympathise the patients? The patients too are at a predicament as they are receiving opinions and treatment that differs from each of the doctors that they sought. In the end, the patients become the 'guinea pigs' as they'll be put to trial on the proposed method of treatment which may or may not work to their benefit.

But I certainly concur with you on the point that "there's no right or wrong answers". It's sometimes through trials and a wait-and-see attitude to get to the root of the problem.

Probably that explains why there are many fine prints to read where hospital paper work are concerned! ha!

doc said...


you & your wife were blessed by God; besides, doctors are only humans & we make mistakes.

doc said...


since the patient is not satisfied with the 1st doctor's treatment, perhaps he should have asked for a CHANGE of doctors, rather than just a 2nd opinion.

the problem, now that 2 doctors are treating him, is this - should he get worse, which doctor should be responsible?

the fine print in the admission/indemnity forms are to protect the hospital, NOT the patient or doctors.

ilene said...

DOC, with regard to your comment, can I ask you whether is there a policy in private hospitals (or among doctors) that a patient is sometimes being denied in a change of doctor? They says there's a code of ethic and it's not advisable for another doctor to take over the conduct of someone else's patient. Is this true?

doc said...


as in any service industry, the patient is the paying customer, & therefore can choose his own doctor(s). the hospital CANNOT deny the patient's right to do so. if this happens, the patient can complain to the CEO, or Malaysian Medical Council. in any case, he can always transfer to another hospital, which i'm certain the 1st hospital would try to avoid (lost income).

however, sometimes the doctors themselves have an unwritten agreement not to intrude into another colleague's patient-care, in which case, the patient again can complain to the CEO if he cannot get a change of doctors.

remember, the patient is the customer and the customer is always RIGHT! the hospital is on the side of the patient as long as he pays the bill.

how else to make a business successful???

Alex Tang said...

Basically I believe it boils down to trust in your doctor. If you trust your doctor, stick with you doctor. If you don't trust your doctor, go elsewhere. Nobody can stop you.

Unfortunately I believe many of our patients (including doctors who became patients) are cursed by two mentalities; (1) The supermarket mentality, and (2) The instant cure mentality. Until this curse is removed, they will be seeking 2nd opinion, 3rd opinion, 4th opinion etc etc.

doc said...

hi Alex,

you're spot on - this particular patient has only been treated for 2days by the 1st doctor, & the 2nd doctor was quite reluctant to even see, but did so only because there are only 2 of them in the sub-specialty.

& doctors make lousy patients!!

ilene said...

Thanks DOC for clarifying the position. Actually, I would be happy to meet any doctor that has got good bedside manners and be compassionate towards the feelings of a patient. There are doctors who create a wall barrier between themselves and the patient for fear of falling in love I presume!

Eh DOC, tumpang lalu .. I want to say a few words to Dr Alex Tang.

Dr Alex Tang, as a patient, we definitely have to trust the doctors as our life depends on them. It's just that when we hear differing opinions, that's when our faith and stable mental faculty turns turmoil!

Every sick person would of course wants to get cured the fastest, easiest and cheapest way right? So that's when the 'shopping' comes in! A norm which is unremovable in any service industry!!

Alex Tang said...

Hi Ilene,

Thanks for your interesting comments.Personally I believe true trust happens when we hear differing opinions but continue to trust in our own doctors.

A norm which is unremovable in any service industry
I beg to differ. A norm in Medicine is the trust and sanctity in the doctor-patient relationship. If there is true trust as I mentioned, then there will not be any need for 'shopping.'

Medicine is a calling and not a service industry though big business is trying to make it so. But they are wrong. And it is wrong for patients to think of medical healthcare as a service industry. If they want to think of healthcare as on par with the hospitality service industry for example, then the loss is theirs.

Unicorn Girl said...

I'm only human , I'm just a woman :) We are never satisfied , aren't we ???

doc said...

Unicorn Girl,

we're human - we want the best for less.

(free, if possible!)

iml said...

In every decision we make in life, the element of luck and faith play a big part in the final outcome. We may have the best and the latest, but to err is human.

ilene said...

Thank you very much Dr Alex Tang for the invaluable advice.

But sometimes it's because of the rising cost in hospital charges that drives a patient away despite the trust that has bonded very well between the patient and the doctor. When funds run low, we start to 'shop' for the next best doctor in a more cheaper healthcare centre and that makes us to be the one at the loosing end.

You may say that medicine is a calling but regretably, with all due respect, not many doctors, especially in the government hospitals, have the compassion or dedication towards their field of work.

suituapui said...

That's the sad part. Sometimes it's something like trial and error... this doesn't work, try this... People would expect doctors to be such smart people - know everything, miracle workers...like doctors in the past. One jab...next day ok already. But I hear they used steriods...which is not encouraged today.

Well, same with teachers. Some good ones, some not so good ones...and hence the need to send them for tuition...and they may not necessarily be telling the poor kids the same things.!

doc said...


not entirely true. sometimes we have the best & latest, & even when no mistakes are made, the outcome still fall short of expectation.

sometimes, we just don't know the will of God.

doc said...


taking up medicine is indeed a calling, but because of the haste of the govt to achieve the magical ratio of 1 doctor for every 600 population & the proliferation of (unregulated??) medical schools, you can expect quite a few students to sneak in the back door.

doc said...


doctors now probably not much different from the past except the expectation now is higher.

steroids are used a lot as a panacea - they provide rapid relief to many ailments but don't cure the underlying disease & cause complications on long-term use.

Yvonne Foong said...

Hey Doc. Have you been following my blog recently? When I came back from the December surgery and realized that I will need surgery again soon, I started feeling sorry that I need to raise funds again. Taking other people's advise into account, I went to seek a second opinion locally. But I could not bear departing from my surgeon's care and was scared to have surgeries locally. Nothing much turned out from seeking second opinions from local surgeons. Now that that short phase of ambigutaty is over and I feel more assured to remain under the care oy my HEI surgeons, I started to see the silliness of even trying to get a second opinion locally. If I were those surgeons, I'd think, "Geez... this girl already has the best doctors. Is she trying to mock me?"

Oops! I don't mean that. So I guess we shouldn't be shopping around too much if we have already found our trusted doctors. I can understand why the doctor would feel too.

doc said...


i drop by on & off, but didn't comment till recently. perhaps you were overly anxious & that's why you sought 2nd opinions - even when you already have the best doctors looking after you.