How employers can increase employee use of second opinions

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When an employee faces a serious health problem or is told he or she needs surgery, seeking a second opinion from another physician can, in some cases, have a significant impact on their diagnosis, treatment plan or prognosis.

But too few patients seek second opinions, and it’s causing issues for both employees and employers.

A Gallup poll found that 49% of the 5,000 survey respondents said they never seek a second opinion when their physician diagnoses a condition, prescribes a new medication or treatment, or recommends surgery. Not seeking a second opinion in the case of a serious, complex, or rare diagnosis or recommendation for elective surgery is a missed opportunity to lower the risk of misdiagnosis and inappropriate or ineffective treatment.

A recent study by health policy researchers at the Mayo Clinic found that as many as 88% of those who sought a second opinion for a complex medical condition at the Mayo Clinic had a new or refined diagnosis that changed their treatment plan. In contrast, only 12% of those patients received confirmation that their diagnosis was correct and complete.

In addition to the harm caused to patients by misdiagnoses that may have been avoided if a second opinion was sought, there’s also a financial impact. The Institute of Medicine reports that approximately $750 billion is wasted each year in the U.S. on unnecessary medical services and other inefficiencies. Employers also bear the impact in the form of the absence or loss of experienced employees, lowered productivity, and increased insurance payouts.

So what can be done about the problem? Employers can play an active role in educating employees about the benefits of second opinions and the process for getting a second opinion. HR and benefits professionals can take the lead in the education process by providing on-site information sessions, communications through employee newsletters, or printed handouts that outline the benefits of seeking a second opinion for a serious diagnosis or surgery, how employees can go about getting a second opinion, and any available resources that can support employees as they seek second opinions and make medical decisions.

To overcome the obstacles that discourage employees from seeking a second opinion — concern about offending their physician, a feeling of urgency about starting treatment, especially with a serious diagnosis like cancer, and concern that insurance will not cover the cost, for example — employers should:

Let them know most doctors welcome a second opinion. Coach employees by providing ways they can start the conversation about a second opinion with their physician. For example, employees can ask their physician if he or she was facing this diagnosis, what doctor’s opinion would they seek. Or they can tell their doctor they’d like to explore all available treatment options before choosing a treatment plan.

Dispel myths. It’s not common that treatment for most health problems, including most cancers, needs to start immediately after diagnosis. Encourage employees to ask their physicians how much time they can take to seek second opinions and make a decision on their treatment.

Highlight the availability of second opinions and the process for getting one in the insurance and benefits information provided to employees. Case management services available through insurance plans and as a standalone service can contact employees who may benefit from a second opinion and walk them through the process.

Let employees know about remote second opinion programs. Thanks to advances in technology, patients no longer need to travel to a healthcare provider to get an expert second opinion. A growing number of centers of excellence, including the Massachusetts General Hospital, Yale, Cleveland Clinic, and Dana Farber Cancer Institute, offer virtual or remote second opinion programs. There are also institution-independent vendors that offer these services.

If your health plan provides coverage for second opinions in- and/or out-of-network, make sure employees are aware of this benefit. If there is no insurance benefit for second opinions, inform employees that money deposited into health savings accounts, if available, can be used to offset the cost.

Encourage employee engagement in healthcare decision-making through incentives, such as cash back for taking an active role in managing their health risk factors, and digital, interactive tools like apps, videos, and e-newsletters that promote healthy behaviors and active participation in decision-making.

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