Tuesday, July 29, 2008

Assembling opinions

Teddy Kennedy was diagnosed in May with a bad brain tumor (a glioma) that initially appeared unresectable. Then, to the surprise of many doctors, he left Boston and Mass General and underwent a three-and-a-half hour surgery at Duke. Kennedy made his decision after convening a group of the nation's leading surgeons and oncologists to hash out his options, a process that the New York Times describes in an interesting article today:
The meeting on May 30 was extraordinary in at least two ways.

One was the ability of a powerful patient — in this case, a scion of a legendary political family and the chairman of the Senate’s health committee — to summon noted consultants to learn about the latest therapy and research findings.

The second was his efficiency in quickly convening more than a dozen experts from at least six academic centers. Some flew to Boston. Others participated by telephone after receiving pertinent test results and other medical records.

Except for the circumstances, telephone participation and the number of invited experts, the meeting resembled the tumor board meetings that specialists regularly hold in their hospitals.
This was pretty much my fantasy of how I might devise a treatment plan. Needless to say, it didn't work out that way. One of my few regrets to date about how we went after this disease was that we only talked to one outside surgeon, who was fairly conservative. Although his credentials were sterling, we should have talked with another expert at another center. 

While you're not going to assemble your own all-star tumor board, acquiring a second or third opinion, the story says, isn't out of reach of non-Kennedys, and may not necessarily require an expensive trip to another state: 
Several doctors not connected with Mr. Kennedy’s case said in interviews that they admired his resourcefulness in getting more opinions simultaneously. At the same time, these doctors said many average patients gained competent advice, without a command performance, by sending pertinent records to experts for their opinions.

Many patients search the Internet for medical information and ask that their scans and other data be sent electronically or by overnight services.

Then such patients visit, call or write the consultant.


1 comment:

L said...

It would be interesting to test this advice. It sounds great but in real life with no strings pulled by a doctor or anyone else, would a specialist really take the time to study scans and offer an opinion without a clear way to bill for the service? Not to mention that we've had agonizing waits for opinions from people we were paying.