Creating Collegiality with Colleagues: Part II

Neil Baum, MD, and Neeraj Kohli, MD, MBA

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School
New Orleans, LA, and author of
 Marketing Your Clinical Practice-Ethically, Effectively, and Economically, Jones Bartlett Publishers.

Neeraj Kohli, MD, MBA, is Director, Division of Urogynecology, Brigham and Women’s Hospital, and Assistant Professor, Department of Ob/Gyn, Harvard Medical School, Boston, MA.

I (NHB) can count on one hand the number of second opinions that I have seen in which I don’t agree with the treating doctor. In the cases in which I don’t agree with the first opinion, rather than telling the patient that I don’t agree or taking over the care of the patient, I call the treating doctor on the phone and tell him/her my findings and my suggestions. Since there are two divergent opinions and the patient is seldom able to make a decision between the two opinions, I tell the patient the situation and suggest that a third opinion be obtained. I would usually recommend that he/she see an academic physician at one of the medical schools. I provide the patient with the findings from my evaluation, as well as the laboratory and x-ray reports, and I ask that the results of the third opinion be sent to BOTH doctors.

Bottom Line: Medicine is not a perfect science and there are bound to be divergent opinions from two doctors. Being up front and forthright with your colleague and putting the patient first is the ethical and appropriate way to manage this situation.