Browsing for a second opinion

Internet sites offer to review cases without examining the patient. Is that a good idea?

By Tyler Chin, AMNews staff. April 23/30, 2001.

Since the beginning of the year, FindCancerExperts.com has handled up to 150 requests a month from recently diagnosed cancer patients seeking referrals to nationally recognized pathologists who can provide second opinions on their initial biopsy results.

"That tells me there is demand," said Barry M. Shmookler, MD, a surgical pathologist who founded the company, which serves as a middleman between patients seeking second opinions and the experts willing to provide them.

FindCancerExperts.com, Rockville, Md., is one of several sites that have sprung up over the past several years offering second opinions to patients without face-to-face consultations.

Another is MDExpert.com, headquartered in Palo Alto, Calif. Its oncology experts don't need to see patients in person because they aren't treating or diagnosing, said Julian C. Schink, MD, a gynecologic oncologist at the University of Wisconsin Comprehensive Cancer Center in Madison and co-founder of the company.

"We're rendering an opinion of someone else's diagnosis and treatment," Dr. Schink said, adding that those opinions may include additional therapy recommendations for the treating physician to consider.

Pathologists routinely render thousands of second opinions without seeing patients, said Dr. Shmookler, who plans to resume practicing now that his company is off the ground.

"That's the nature of the specialty," he said. "We don't see patients. We see tissue and biopsy and rely on the clinic to provide information if necessary. If I need more information, I'll just call the [treating] doctor and say, 'Hey, Joe, I just did a little biopsy. How long has this been going on? What did the x-rays show?' " [...]