Why it is Crucial to Seek a Second Opinion for Surgery

Posted on October 27, 2010

In the early 1980s, Dr. Thomas Graboys, a doctor at Harvard Medical School, was highly sought out for second options by patients across the United States who had been told they needed to undergo bypass surgery because they had a high risk of suffering a heart attack. Graboys often cited a study done by the National Heart, Lung and Blood Institute, which followed patients for five years who were experiencing blood vessels to the heart narrowing. The study found that in most cases, medical therapy was just as effective as surgical therapy.

Graboys also conducted a study of his own, reviewing the medical records of 100 high-risk heart disease patients who were candidates for bypass surgery, but he believed surgery was unnecessary. He found that 76 decided to forgo the surgery; and 18 months later, 75 were alive. Of the 24 patients who decided to have surgery, after 18 months, two had died. While statistically these results are essentially the same, it does show that bypass surgery isn’t right for everyone.

A 1985 article in Health Letter, a publication of Public Citizen, found that between 1971 and 1978, bypass operations performed on men 65 and older rose by an alarming 955 percent. The bypass rate for younger people also rose sharply. In 1985, with bypass surgeries costing about $20,000, Graboys estimated that for every 100 patients who decided, based on a second opinion, to forgo or delay a coronary artery bypass, approximately $1.4 million could be saved in medical expenses.

Many patients aren’t aware that bypass surgery isn’t a cure-all for coronary artery disease. In the surgery, a graft is inserted to be used as a detour around a blocked artery. The graft can narrow over time and require patients to undergo a second operation years later.

The article in Health Letter notes that complication and mortality rates from bypass surgery are low, but not zero. There is a small risk associated with the procedure, such as the risk of heart attack, the risk of dying from the surgery, as well as the risk of post-operative problems occurring, such as infection or stroke. The article also notes that elderly people are at a far greater risk as well. Thus, the conclusion is reached that it is in fact a good idea to “think twice” before undergoing bypass surgery, as fewer deaths could occur and millions if not billions of dollars could be saved if more patients sought second opinions before undergoing surgery.

If your doctor has recommended bypass surgery or another extensive procedure for you, it is a good idea to consult another physician for a second opinion. Ask a local medical school or medical societies which doctors they recommend to treat your injury or illness. Doing so could save you money in the future, even if you have to pay the cost of a second opinion out of pocket if your insurance won’t cover it. If you discover the procedure isn’t necessary, you will not only be spared expenses associated with the operation but the additional risks of unnecessary surgery.

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