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Wednesday, September 10, 2008 9:00 AM

Navigating Health Care: How to Deal with a Difficult Diagnosis

Rand: Being diagnosed with a serious or even life-threatening disease is very stressful and confusing. But getting good quality information can help you make better decisions about your health care options. AHRQ Director Dr. Carolyn Clancy has some tips for navigating the health care system after getting a difficult diagnosis. Dr. Clancy, thank you for joining us.

Dr. Clancy: My pleasure.

Rand: Let’s start with your advice, as a doctor, for handling the news.

Dr. Clancy: Being told that you have a new diagnosis, especially if it’s a serious condition, is a very frightening experience to go through. To some extent I think most people need to realize that you’re going to go through that emotional firestorm, if you will, and what’s very, very helpful is if you have someone with you, someone who can pay attention, who is not being directly affected by this news themselves.

Rand: So, how much more information should people about their diagnosis before deciding on a treatment option with their doctor?

Dr. Clancy: A lot will depend on what the diagnosis is. There are some conditions for which there is one pretty clear path about what needs to happen next and the decisions are going to revolve around where and when to have the next set of treatments taken care of and so forth, and/or diagnostic tests for more precision. There are other conditions where there’s going to be two or more alternatives and that is where decision-making gets a bit more complicated.

Rand: And maybe overwhelming?

Dr. Clancy: I think a very important take-home message for most people is that it is highly unusual that you actually have to make a decision right now. You actually have time to stop and think, to take some really deep breaths, to actually look for other information, to ask questions about alternatives, and so forth.

Rand: What about getting a second opinion?

Dr. Clancy: Second opinions can be very helpful if you need reassurance that the choice you’re making is right for you, that it makes sense, that it’s going to be the right balance for your situation between benefits that you’d expect and potential harms or adverse effects. Most good physicians would welcome a second opinion, especially if there’s any lack of clarity about the diagnosis and what the next treatment steps are. Occasionally some will be a bit resistant and defensive. It’s important to know that. It can be very important at that point to have a friend or family member with you.

Rand: So, how does one get a second opinion?

Dr. Clancy: It can be a little bit tricky to get a second opinion. Occasionally, physicians will refer patients to one of their colleagues, immediate colleagues, for a second opinion. That’s probably not the best idea in terms of getting an independent assessment. Often times it takes a little bit of thought before you go in for a second opinion to figure out, how do I ask this question in a way that doesn’t make it sound as if what I’m saying to the second doctor is what did you think of doctor number one. Because what you’re really there for is simply an independent assessment.

Rand: Dr. Carolyn Clancy, thank you.

Dr. Clancy: Thank you.

Rand: To learn more about your choices and sources for quality information, check out AHRQ’s guide, called "Next Steps After Diagnosis," available online at ahrq.gov/consumer.

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