How to Create Collegiality in a Difference of Opinion: Part 2

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Neil Baum, MD

Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA

Author, Marketing Your Clinical Practice-Ethically, Effectively, and Economically, Jones Bartlett Publishers


I can count on one hand the number of second opinions that I have seen where I don’t agree with the treating doctor. Rather than tell the patient that I don’t agree or take over the care of the patient, I call the treating doctor on the phone and tell him 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 they see an academic physician at one of the medical schools. I provide the patient with the findings from my evaluation, the laboratory and X-ray reports and ask that the third opinion send both doctors the result of the third opinion. 

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