Health & Wellness, Living with Breast Cancer

Curbsides: the water cooler second opinions

By Dr. Shelby Terstriep

August 5, 2013

In oncology, we get asked a lot about the need for second opinions from patients. It is often something like “Do you really think I need a second opinion?” or “My family is saying I should get a second opinion.”

Most patient resources imply that if you don’t seek out a second opinion, you haven’t done your due diligence as an informed and determined patient. I’m not sure if I agree with that.

Some people will truly benefit from hearing another plan from someone else. It may sink in better the second time. It may be more in line with what they actually desire. It may be that they feel a better connection with that person. They may feel “listened to.” Another doctor may be better at explaining something. Or maybe it feels that they then have exhausted all avenues and are therefore able to make the best choice.

For others, second opinions can be expensive and confusing.

water coolerHealthcare professionals have a word that implies a quick second opinion: curbside. It happens by the water cooler, printer, nurse’s desk, in the hallway, through phone calls to different specialists around the country, and via social networking. The conversation usually starts out, “Can I curbside you about a patient?”

I’ve recently thought about all the “second opinions” for my patients that I truly get in one day through “curbsides.” It is a lot. What’s your experience? Have you had a case like this? Should I think about this differently?

While there are no “super secret cancer treatments” that I learn from these “curbsides,” it often validates what I was already going to do. I also learn practice styles, nuggets of information, and different perspectives of varying practitioners. We all come from different perspectives in life and, when handling unusual situations or challenging cases, I want a lot of perspectives.

So if you need a second opinion, I think that is fine. . . BUT I also think it is fine to not get one, if you:

  • already feel “listened” to;
  • can speak honestly and openly to your doctor;
  • know and trust that your doctor is getting their own “curbsides” when they should;
  • know that your doctor will refer you appropriately to another provider if there are services his or her institution does not offer.

 
The truth is that ALL my patients get second opinions. With many of them, I just happen to be the one organizing them in a framework and plan—and hopefully guiding them according to their goals and wishes with compassion and care.

  • Kimberly J. Byrd Lucas

    I was glad to come across this post because when I chose not to get a second opinion before going through treatment. Why? Because I’d already researched what my options were, and the ones my doctors offered were exactly the ones I expected. Thus, I felt no need to second guess them.

    As a trained librarian, I felt qualified to decide between legitimate resources for information and quacks. Also, my job makes it almost impossible for me NOT to research anything I consider important. Fighting cancer definitely fell under that category. Had any of my research turned up different treatment options than those my medical team suggested, I might have felt differently. As it was, I was very happy with how I was treated. My cancer was run-of-the-mill ductal carcinoma (if there is such a thing), and I was fortunate to have a range of options to choose from for treatment. My doctors listened to what I had to say, answered my questions, and ultimately let me decide.

    • Shelby Terstriep

      Kimberly thank you so much for you insight! I would love to know your criteria for choosing good information and bad information. . . maybe we should do a blog about !

      • Kimberly J. Byrd Lucas

        Gosh, Shelby, it’s been a long time since I attended library school, so the criteria has become almost internalized. However, an authoritative source would be one that’s recognized by those in the field based on reliability, accuracy and currency. I would ask myself the following questions:

        1. Who wrote this information? What is their background, education, expertise? Do others recognize them as a leader in their field? Or are they merely trying to sell books?
        2. Who is the publisher of this information? Generally I would question the information in a self-published book from someone who claims to be an expert. (Confession: I do plan to self-publish the “Cancer Lessons” from my blog as a memoir, but that’s different from claiming to be an expert on breast cancer).
        3. How current is this information? If it has to do with science or medicine and is over five years old, throw it out. If it’s over three, verify with other research that the information is still accurate. And, please note — just because the information is on a website doesn’t mean it’s current, even if it was posted yesterday. The important thing to know is when it was written.
        4. Also, if the information is on a website, is it a reputable site? I tend to look for information posted by the government (NIH), non-profit organizations (cancer.org) and hospitals.

        I don’t generally recommend the true medical journals for most people because few of us could understand them. I had breast cancer, so I tend to recommend Dr. Susan Love’s book, with the caveat that it’s due for an update.

        Okay, end of library science lecture. That’s all I can think of off the top of my head.

        What do you look for and/or recommend for your patients?