NCPA - National Center for Policy Analysis

Internet Second Opinions

April 24, 2002

Empowered consumers have long used the Internet to seek medical information. Now hospitals and private companies are filling a new Internet niche: on-line second opinions.

The patient or the patient's physician registers at the Website by providing contact information and a case history. Within a few days, a report with treatment recommendations is sent to the patient's doctor who then discusses the results with the patient. In most cases, the consulting specialist never meets or speaks to the patient.

Among health systems offering on-line second opinions and consultations are prestigious firms such as Cleveland Clinic, Johns Hopkins, the University of Texas M.D. Anderson Cancer Center and others.

For example, Partners HealthCare System in Boston began its On-line Specialty Consultation service in 2002.

  • In less than one year, about 300 patients have paid the $600 fee (often out-of-pocket) for second opinions from the health system's nearly 500 specialists.
  • The service includes a review of medical records, biopsy samples and images, followed by a written report on treatment recommendations.
  • Patients seeking second opinions tend to be chronically ill and facing some major decisions about the course of therapy or a dilemma over the diagnosis.

However, legal and ethical questions remain. For example, can a doctor in Massachusetts provide medical advice to a patient in Nevada? Many state laws were written long before the Internet and do not cover legal questions raised by the practice of telemedicine. Second-opinion services get around this issue by dealing doctor-to-doctor and not directly with patients. And the advice given isn't a diagnosis although the original diagnosis may be questioned and new tests may be recommended.

Another concern is malpractice risks. Some physicians worry that on-line doctors may make medical judgments without complete information.

Source: Sidney Stevens, "Docs-on-the-Net Consults Offer Second Opinions," Physician's Financial News, March 2002.


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