A second opinion from London when you live abroad

What a second opinion from London involves

A second opinion is a review of your diagnosis or proposed treatment by a consultant who has not treated you before. From abroad, the consultant reads your records and looks again at the original scan images and any pathology, then talks the findings through with you, by video where the consultant offers it or in person in London, and writes a letter for you and your own doctor.

You do not need to live in the UK or be registered with a doctor here. What you need is a clear question and the records that bear on it, shared with your consent.

How often a second opinion changes the diagnosis

Most second opinions confirm or sharpen the first, and a meaningful minority change it. In a study of 286 patients referred from primary care to a large American academic centre, the final diagnosis was distinctly different from the referral diagnosis in 21% of cases [1]. In 66% it was better defined, and in 12% it was the same [1].

The picture varies by specialty. A systematic review of 33 studies of second opinions that patients sought for themselves found that many confirm the original diagnosis or treatment, while differences between opinions had a potential major effect on outcomes in up to 58% of cases [2]. When a specialist pathology department reviewed 6,171 cases sent in from other hospitals, 1.4% of diagnoses changed in a way that altered treatment or outlook [3].

Scans show a similar pattern. A second reading of 4,534 brain and spine scans performed elsewhere found clinically important differences in 7.7%, and where the readings differed and a final diagnosis could be established, the second reading was correct in 84% [4]. These figures come from specialist centres and selected patients, so they describe what can happen and do not predict your own case.

Records and imaging to send

Send what the consultant needs to form a view without repeating tests. The original images matter as well as the written report, because a second reading looks at the pictures afresh [4]. When a diagnosis rests on a biopsy, the laboratory can send the original slides or tissue blocks, and the authors of the pathology study advise that this material is reviewed before major treatment begins [3].

In the UK you have a right to copies of the information an organisation holds about you, and organisations usually have one month to respond [5]. Rules differ in other countries, so ask your hospital early, as gathering images and slides is often the slowest step.

• A letter or summary from your treating doctor, with the diagnosis and the proposed treatment
• The question you want answered, in a sentence or two
• The original scan images in DICOM format, on a disc or a secure download link, with their reports
• Pathology reports, and the slides or blocks where the diagnosis rests on a biopsy
• Recent blood results with their dates and reference ranges
• A list of your medicines with doses, and any allergies
• Copies in English, or a translation, where you can

Consent and how your data is protected

Your records are shared only with your consent, and only with the people your case needs. The Information Commissioner’s Office, the UK regulator for data protection, explains that information about your health is special category data, which may be used only when extra conditions are met [6].

Before anything is sent, you agree who will see your records, usually the consultant and your doctor at home. You can ask any UK organisation for a copy of everything it holds about you, and it normally cannot charge for this [7]. Send records through a secure link rather than ordinary email, and keep your own copy of everything you send.

What a second opinion can and cannot do

A second opinion can confirm or change a diagnosis, and it can set out other treatment options with their benefits and risks. It gives you a fuller picture before a decision that is hard to reverse.

A review from a distance has limits, because the consultant may not be able to examine you and may ask for a new scan or test before giving a firm view. It does not replace your own doctor, who knows your history and will often carry out the treatment, and when two opinions differ you may need a further conversation before you decide.

There are costs to weigh as well. Gathering records takes time, which matters when treatment is urgent, and a different opinion can bring uncertainty before it brings clarity. Ask your own doctor whether waiting for a second opinion is safe in your case.

Who it suits and who it does not

It suits you if you face a serious diagnosis or a major operation and want another expert view before you commit. It also suits you if your symptoms remain unexplained after tests at home.

It is not the right route for a sudden or worsening illness, which needs a doctor where you are. If you have chest pain, sudden breathlessness, signs of a stroke or severe bleeding, call 999 in the UK or the local emergency number. It adds little for a clear-cut problem where every option leads to the same treatment.

How long it takes

Most of the time goes on gathering records. Once they arrive, a first appointment is offered within 48 hours when the case is urgent and within 5 working days when it is routine, and the consultant’s letter comes back into your record [8].

If the consultant asks to see you in person, plan the visit around the appointment and any tests, and allow time for the results before you fly home.

Questions to ask the consultant

Write your questions down before the appointment, so the time goes on what matters most to you.

• Do you agree with the diagnosis, and how sure are you?
• Which other treatments would you consider, and why?
• What would happen if I waited, or chose no treatment?
• Is there anything you could not judge from the records alone?
• What should my doctor at home do with your letter?

How The Wellness can help

Navigation is £295 for one case, or included in membership. Your liaison finds the right consultant for the question, gathers the records and images, arranges any tests around the appointment and brings the letter back into one record you can open from any country [8] [9]. You approve every booking, and the consultant’s own fee is told to you before you agree.

Every doctor is GMC registered, and regulated services are delivered through registered partner clinics and accredited laboratories. Our London clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia, and appointments can also be arranged with partners in 12 city pages beyond London. We consult in English and in Arabic, and bring an interpreter for other languages.