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Human rights and rapid tranquillisation
Published in Bernadette McSherry, Yvette Maker, Restrictive Practices in Health Care and Disability Settings, 2020
Peter Bartlett, Stephanie Sampson
The Second Opinion Appointed Doctor requirement raises a different set of difficulties. Second Opinion Appointed Doctors are appointed and dispatched centrally by the Care Quality Commission. With the best will in the world, it may well take at least days for the Second Opinion Appointed Doctor to visit the hospital, consider the case and express a view. If the Second Opinion Appointed Doctor is approving the plan for intervention developed when the patient is initially admitted, this may be workable. However, if an intervention is required which is not anticipated in the plan, as in a case of real and unanticipated urgency, it is difficult to see that the Second Opinion Appointed Doctor will be able to respond sufficiently quickly to make the Mental Health Act justification practical.
Workers’ Compensation Case Evaluation
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
A second opinion can help clarify a complex medical picture or suggest alternatives to a current or proposed treatment. This is presented to the claimant as proactive, and a case manager or LNC will usually attend. This is usually called for when there is a conflict between potential treatment plans (e.g., surgery versus conservative care), when the claimant requests one, when multilayered medical scenarios or a questionable treatment is under way, or when the existing treatment plan has not achieved the expected outcome (Mullahy, 2014). In contrast to IME, the patient may choose the second opinion provider to become the treating provider.
Management of chronic myofascial pain: finding common ground
Published in Kirsti Malterud, Steinar Hunskaar, Chronic Myofascial Pain, 2018
Kirsti Malterud, Steinar Hunskaar
Many practitioners claim that it is very difficult to shift from consultations where the aim is to cure, to consultations with new content and methods in a setting where the first strategy has failed. In some sense, the doctor has not managed his/her first and primary goal; to cure the symptoms. This may give him or her a weakened position towards the patient. Will the patient still have confidence in her/him, although he/she has failed? It is not unreasonable that the patient may want a second opinion, or ask for a referral to a specialist. Many questions and expectations may not be resolved in open discussion.
Pathology Reports: Discrepancy Patterns of Second Opinions in a Referral Cancer Center
Published in Cancer Investigation, 2023
Shirin Taraz Jamshidi, Masoumeh Gharib, Mohammad Etemadi, Lida Jarahi, Sare Hosseini, Mona Ariamanesh, Mansoureh Dehghani
Several historical studies have evaluated the impact of second opinion review in surgical pathology since the early 1990s. The diagnostic discrepancy rates ranged from 0.25% to 24%, and several of these studies have demonstrated that patient management was directly altered by asking for a second opinion review (2–5). Hence, pathology review has become a compulsory policy in many centers to re-examine and confirm the initial diagnosis, and avoid unnecessary or irrelevant treatment interventions (4,6). Another reason for the policy of asking for a review is that many medical and hospital centers do not have reporting guidelines, so the pathology reports received from primary centers usually have deficiencies leading to a lack of information that makes it difficult to make the right decision for patient care (6).
Multiple Granulomas of Ocular Toxocariasis in an Immunocompetent Male
Published in Ocular Immunology and Inflammation, 2020
Aniruddha Agarwal, Pranab Das, Aman Kumar, Suryaprakash Sharma, Kanika Aggarwal, Shobha Sehgal, Vishali Gupta
Despite therapy, there was no symptomatic improvement, and the fundus lesions continued to increase in size (especially the inferonasal voluminous lesion) (Figure 1). At this stage, the patient was referred to our clinic for a second opinion. Optical coherence tomography (OCT) scan passing through the lesion showed retinal disorganization with significant thickening and subretinal fluid. There was overlying dense vitritis (Figure 2). Fluorescein angiography revealed mild hyperfluorescence with increase in the late phase in the area of the lesion (Figure 2). Additional investigations were performed to rule out any systemic immunodeficiency (thinking of a viral etiology). Repeat HIV testing was performed, and the results were negative. Serum immunoglobulin levels were normal, and isolated CD4 deficiency was ruled out (absolute CD4 counts from peripheral blood were more than 700 cells per cubic millimeter). Oral antivirals were continued, and the corticosteroids were tapered and stopped over the next 2 weeks. Since the patient was already on oral antiviral therapy, we decided to perform a definitive diagnostic pars plana vitrectomy (PPV) and determine the cause of inflammation. Meanwhile, we decided to taper and stop the oral corticosteroid therapy and obtain basic laboratory investigations before proceeding to surgery.
Youth and young adults with acquired brain injury transition towards work-related roles: a qualitative study
Published in Disability and Rehabilitation, 2019
Alicia Paniccia, Heather Colquhoun, Bonnie Kirsh, Sally Lindsay
The support from healthcare professionals was typically one of the first points of contact for many participants after their ABI. The exchange of information shared during these interactions were critical because it shaped participants’ expectations of what their ABI impairments would look like; how long their recovery would take and provided them with recommendations on how to proceed. Participants said that rest, reduction or elimination of physical activity, and reduced work-related roles were their healthcare providers’ top recommendations. While some participants found that these recommendations were beneficial, others found it difficult to adhere to such a large change in lifestyle, or felt they were not being taken seriously. As a result, participants often decided whether their healthcare professionals’ recommendations were adequate, or if they should seek a second opinion. For example, as one participant’s ABI symptoms worsened over time, she became frustrated at the lack of attention she received from her physiotherapist since the ABI’s onset: