Second opinions

[@tanakaba]

My Dad stopped eating and lost weight over the course of a few weeks, eventually going to the hospital for two weeks after he became faint and passed out. On the first day at the hospital, after tests, they found the lining of his colon was sloughing off. The reason he lost appetite was because his body couldn't pass the food. First doctor said they would have to remove part of the colon, and he'd have a colostomy bag the rest of his life. Dad declined. Second day, doctor came back for a signature. Declined. Third day, second doctor, same plan. Declined. This went on for about a week. Finally, fourth doctor comes in with an idea. Stop taking some of the medication Dad takes from having an organ transplant. Next morning, Dad has an appetite and eats breakfast. Turns out, insurance had made him switch to a generic and some kind of allergy/side effect was causing the damage to his digestive system. They got him on a replacement medication, and he was released shortly after.

[@billyhughes9776]

First of all, I hope your father is doing well now. The first three Docs should be stripped of their medical credentials for not doing their due-diligence.

[@trucid2]

"First, do no harm" is not even an afterthought.

[@r-jproductions1343]

Oh my I can't believe this. Those doctors shouldn't be practicing medicine.

[@antonpiskernik7824]

Many thanks for sharing your revealing experience!!❤ [Sometimes in my 30ies I had decided to live according to the follwing Maxime for similar reasons/observations: "You yourself are your best doctor", which became my compass- though sharing with/learning from others can also be crucial. My faith in the Most High has also proved to be very helpful..]

[@helicart]

Good doctors should consider a priori about med side effects.....but on the whole don't. If Ai has one field to improve profoundly, it is medical diagnosis. Most doctors are just not smart enough to develop and rigorously use clinical algorithms.

[@donaldlewis567]

Went to Mayo Clinic (living in Rochester at the time). Husband was diagnosed with HIV. They even announced it at the front desk when they were making an appointment for follow up. The test was indeterminate when I read the labs. Went to the local Olmsted Medical Center community center and they did confirmatory tests which were negative for HIV. Will never forgive Mayo for the stress they caused over those few weeks/months.

[@MrGiggitygoo31]

They have this stupid procedure that has to alert a person even if a test was indeterminate. It's worded so bad it makes you think you have it. Years ago a wife read a letter that her husband has some STD ( he didn't) and it sounds like they never changed that policy or wording. I'm sure this happened more than the one time (was told by someone who worked as a quality worker there). Apparently in your case, even the workers can't tell the difference. OMC has superior care. Mayo has the resources. Best thing is to leverage both on their strengths if you can by avoiding Mayo for care unless you need their trials or resources/specialty.

[@cellgrrl]

All the prestigious medical centers are now no longer that. They are not to be trusted.

[@lauratroyer6897]

I had a very rare cancer that no one at the Cleveland Clinic had ever seen. I got very good care from other gyn oncologists in Cleveland and Akron because they were willing to research and reach out to others about my treatment. I got very good care and have been cancer free for 10 years.

[@sliglusamelius8578]

What was the cancer, if you don't mind saying?

[@lauratroyer6897]

@sliglusamelius8578 it was an adenocystic cancer of the bartholin gland

[@sliglusamelius8578]

@@lauratroyer6897 Yeah, that's rare. Hope you're doing ok..

[@lauratroyer6897]

@@sliglusamelius8578 doing well. It's been 10 years since my diagnosis. Thanks!

[@autumna9601]

Dr. Prasad, I appreciate your insight and know that you are a thoughtful and caring MD. I have learned so much from watching your videos. I am a RN at an academic medical center. Worked there for over 35 years. I have seen good MDs and not so good. Love your candor and expertise. I know you are one of the great MDs at your facility!

[@Logi_Queenie]

pharmaceutical companies ARE the medical field at this point in America

[@barbaraberwick8993]

Dr. Prasad, it would be extremely useful if you could talk about what questions a newly diagnosed patient should ask..I went to the original oncology appointments with one friend and now I am going with another. As a nurse, and as person who has listened to many of your talks I do know some things that I feel need to be asked. For instance, since my friend is 78 years old, otherwise in good health, we need to know what would be the "statistical average" of treatment vs no treatment in actual overall survival and in quality of life. However, I know that it is extremely hard for doctors to give that information because it is truly hard to know. However, there are probably ways of asking those types of questions that could help provide answers. Perhaps, you could make a video explaining the best type of questions to ask. Even if you don't, thank you for all you have done and continue to do

[@Vantasticviews2]

I know nothing about cancer (and hope I never have to learn) but I so appreciate your honesty, integrity, and most of all, your willingness to call it like you see it. Rock on!

[@Mjmsc]

My advice - and I get this from watching Vinay - and I’ve changed my practice to match - be able to reference actual studies when discussing complex or controversial treatments. If you tell a patient a guideline, know if it’s expert opinion or science based and be honest. Admit when you don’t know something. It gives you the biggest upper hand to getting good outcomes - patient trust and buy in.

[@Titor3]

In my experience the large cancer center had MUCH better quality of care and quality of life. Stage 4 Burkitt Lymphoma survivor here - a second opinion at MSK in NYC was a huge upgrade for me. My local hospital suggested a more toxic chemo R-CODOX-M/R-IVAC and wanted to start the regimen in a couple weeks due to scheduling and overall the local oncologist seemed nervous/uncertain about my case. The second opinion at MSK proposed to start chemo the very next day and they cited research to show that there's a better regimen with less toxicity DA-R-EPOCH. MSK has relationships with other hospitals to get me admitted that next day. They also had take-home chemo bag systems that local hospitals can't offer. And the facilities are run incredibly well. The staff is highly attentive, the hospital makes smoothies for when mouth sores prevent eating (I couldn't eat for two weeks with mouth covered in sores), etc etc many other things. 5 years cancer free thanks to them and so incredibly grateful

[@omgzfuup]

Congratulations! Thank you for sharing your story!

[@CharisseBirdwell]

Sometimes these "top cancer centers" want to bill your insurance for every test they can think of and then tell you, we recommend that you return in 6-12 months for more testing.

[@dianne.murielrobidoux9008]

Now wow! The vinay we want and appreciate ❤

[@mikaelamacnaughton4768]

Thank you for your important work! Thanks for having integrity! May you inspire many other great physicians to have the courage to

[@JYAN2852]

My late brother (pancreatic cancer) went to Dana Farber for 2nd opinion with high hopes only to be told to follow his current chemotherapy treatment. They only recommended him to participate in clinical trials. He died from chemo side effects eventually within a few months. His cancer never grew. Died from malnutrition and cachexia not from the cancer.

[@poodledaddles1091]

So sorry:(

[@FourthWayRanch]

Dana farber is a tool for venture capital to steal from the sick. I have first hand experience working as a chemist for a company running trials associated with Farber. The CSO claimed to have a PhD in pharmacology from Harvard, it was all a lie, the guy was a vet from the carribbean. When I told Farber they just ignored me, don't trust them

[@lydiajoymcdowell-davis3390]

Oh no, I'm so sorry

[@sliglusamelius8578]

Cachexia is from pancreatic cancer. Look it up, many cancers terminate patients from cachexia, pancreatic especially.

[@DaemonGeek]

Once again, Vinay, you provide a thoughtful and reasoned discussion on a medical topic which is helpful not only to the lay public, but to other practitioners as well. I always enjoy taking the time to watch your videos, and rarely do I consider that time not well spent. Kudos!

[@kk70x7]

ONC research manager for pharma for 10 years. Worked with all the big names along with a spectrum of investigative sites. I can say HANDS DOWN I would not send a family member to the big names unless they had something very rare. Operations at the big centers was on the edge before COVID and then the pandemic broke them. They are a total mess! Yes, they run a ton of trials and have KOLs but they are just not invested in actual patient care.

[@FourthWayRanch]

@@kk70x7 then you also know a lot of the "trials" come from VC backed startups looking to flip an IPO on the stock market.

[@jakec5618]

Thank You for shedding light on it.

[@jedidiahdavis7147]

Praise God this is not advice i need at the moment but i will definitely hang on to this advice on case of such a time. Thank you as always, Dr P!

[@Photoshop729]

You wouldn’t believe how many times I went real doctor after real doctor only to find the solution on some random KZbin video. Doctors can only do 2 things: give you drugs or do surgery. If you don’t want those two things you are on your own.

[@donnamoss7480]

There

[@Superfatcat2525]

Truth

[@dedetudor.]

You got that right for sure.

[@ExpresslyVPNed]

That's factually incorrect. We also run tests, obtain imaging, refer to specialists, do counseling, and importantly, advise against drugs and surgery.

[@chrisfrank5991]

@@ExpresslyVPNed Factually, sure. Practically, though, doctors run tests and imaging and refer for the sake of deciding if there is a drug or surgery that can solve the problem. If not, we are sent home to find our own solution via KZbin such as a change in diet and/or supplements and/or exercises that the doctor either was unaware of, or advised against or laughed at as quackery. Indeed, many of the things on KZbin don't work, but same can be said for many of the things doctors have prescribed. Worked in medical products industry for a while, we had a product for women with urinary incontinence for whom drugs did not work and their doctors just treated them like they were crazy when the standard drugs failed to work. When they discovered our product actually worked for them they were more relieved to find out they weren't "crazy" than to have the medical condition solved - that's how bad it is out there! Anyhow the product was an implantable neurmodulation device - FDA approved.

[@joannabusinessaccount7293]

The higher the academic titles, the busier these star doctors have to tend to writing grants, attending meetings, playing politics, dealing with finances etc. Translation: less time and soul with patients.

[@margotbw4660]

You were AWESOME at the Stanford Covid Policy Meeting! Comments are off over there, but wanted to thank you for your participation on that panel!!! Also, that was a bad cough you had, hope you are feeling better!!

[@casselfriemel]

Hi VP! I 100% agree...I always tell pts that a second opinion won't hurt my feelings, but just because the 2nd opinion doc @ Mayo/MDACC/etc recommends a certain treatment, there is always room for discussion -- we all trained at these centers and realize that these MDs are not gods, and many are not super intellectually gifted. The tertiary care center oncs also have little experience w/ community cancer care, and there are always many other tx paths other than the "expert recommendation".

[@reapop-u3n]

"Thoughtful reasoning and explanation." Sure seems simple enough. It's so satisfying to watch Dr. V roast the "experts."

[@raymac6262]

As always, sound reasoning and moral clarity from Vinay.

[@wisenber]

Every case is unique, but some types of cancers are more rare than others. I was with my friend 14 years ago when she was told she had about 40 months and should get her affairs in order when she was diagnosed with advanced Waldentrom's. The trip from Tennessee to Dana Farber to see Dr. Treon (while he was still seeing patients) made a huge difference in her first line of care and her overall optimism about her prognosis. She still has a local primary oncologist (the first one is now retired), but we still go to Boston once a year to see what new treatments are on the horizon for when her current BTK inhibitor stops responding....instead of getting her affairs in order. Some times it works, but yeas many are just a money grab.

[@Skandalos]

Trust breeds fraud and corruption. Distrust is my greatest tool.

[@jannz1942]

We actually got THREE opinions because the first TWO opinions were conflicting. This was about our then 14yr old son needing a knee surgery. One opinion would have cut into his 'growth plate' and he hadn't finished growing. The second opinion pointed this out ... and the 3rd opinion confirmed the concern the 2nd opinion.

[@trog.lodyte]

My first urologist was a joke, after cystoscopy showed a tumour he told my wife and I NOT to look anything up, to not become informed. Thing is, my wife at the time was an MD. Couldn't believe it. Got referred away from him right away after my TURBT surgery. I had zero trust in him after that. On my own became educated and found a parallel ivermectin/fenben keto diet (metabolic approach) that doesn't conflict with my BCG immunotherapy.

[@ElizabethDohertyThomas]

Very humbling stuff, as always.

[@janellwoodward1548]

Would have loved your thoughts before I went to Stanford for a second opinion with my cancer diagnosis. Locally I had first doc who let my treatment fall thru cracks and just hope for best without treatment, 2nd doc said, doesn’t matter I’m outside studies, treat it. Stanford agreed with 2nd doc.

[@Aaron-cc7yq]

The best anecdotal evidence I have to support the true claim that a doctor at *insert apparent prestigious hospital* vs a community hospital are no different is my medical school. The same doctors that work at the private fancy hospital are also contracted at the community hospital literally a 5 minute walk across the street. The same doctors work at both hospitals lol. The only difference is one hospital has a piano in the lobby, the other has a medal detector.

[@FourthWayRanch]

My mom got vulvar C at 85. The first center wanted to hit her hard with radiation. I took her to a university hospital for a second, they thought the treatment would have caused her undue suffering. They suggested lighter energy with more days of treatment. She got 3 more years in relative comfort but nothing could stop it in the end.

[@VivaciousOM]

I’m so sorry for your loss.

[@delori]

I'm so glad he brought up that sign. Don't confuse your Google search with my MD. Not only is that sign incredibly condescending obnoxious entitled and kind of narcissistic. It's also calling the patient, stupid and unreliable witness to our own bodies. And the anxiety of bias is right behind it .The biases against many people leave them to have to diagnose themselves. It's either that or nothing. A lot of people successfully do this. Convincing a doctor to listen to your conclusion is another matter.

[@sevenmileshome]

Agree though its a two way street. Patients often search what they want to find and present this to physicians as demands. When a physician counters this preconceived notion of medical knowledge with a different plan, the patient gets upset. The best example is back pain. When patients google it, lots of different things come up. Most lead to some kind of imaging needed to come to a clinical decision. However in reality, most back pain pathologies do not require imaging and in fact is an abuse and waste to order them. The idea that a few hours of "research" on the internet is going to be more informed than a practicing provider with years of experience itself is narcissistic.

[@jamesharcombe45]

A specialist. Someone who gets to know more and more, about less and less, until they know absolutely everything about nothing.

[@debraisel1202]

Reputation means nothing in the centers that do not communicate with their patients. My sister has stage for lung cancer, 24 years after she quit smoking. There has been no coordination between the specialists or with her PCP. She changed cancer treatment centers with not much change in their responsiveness. She will die of this cancer but wants to be comfortable enough to travel short trips and see her granddaughter graduate college in a couple of years. As her retired-nurse baby sister, I can declare both of the cancer centers fecal theatrical performances. I worked at Alaska Native Medical Center where they weren't much on research but they treated the patients like people, the PCPs were linchpins and pain was treated more seriously.

[@jodybessner1145]

Vinay speaks truth to power

[@cynthiam.1368]

Dr. Prasad, there is a new study from China showing benefits from ivermectin on many types of cancer. Would you please weigh in on this.

[@surgicalcapscom]

Medicine is Sick.

[@colinchappell4973]

Bravo Dr. Prasad

[@SymphonicEllen]

I think a second opinion should pretty well be expected nowadays, I agree as far as running to 5 or 6, but I would say if you go to a main stream doctor, and then you feel you're going to ask for a second opinion , I would ask the FLCCC people. They aren't specifically cancer doctors, but I bet you they know some good ones. Love you! XOXO

[@joyfulnoise2477]

FLCCC now has a section on their website including information from Dr. Paul Marik who has been doing research on repurposed drugs (such as ivermectin and Fenbendazole) as well as diet, supplements, etc. to be used in conjunction with "traditional" cancer treatment. People are finding greater success with his regimen. His cancer care guide is available for download on the FLCCC website. Good stuff!! I first ran across him in a KZbin video by Dr. John Campbell and have recommended that video numerous times since.

[@ChrisCapoccia]

Google searches vary wildly by who is doing them and whether they are looking for medical experts or looking for anti medical information. There's also a lot about personality of the doctor that people react to when they are sorting through new information about a tough situation and it can be easier to sign up for a difficult treatment from a doctor you trust will listen and take time to explain questions

[@marchhair01]

As an oncology RN, I counseled a friend that the main reason to go to the big center is if he had a driver mutation and the only way to get the therapy was on clinical trial that is not open locally. He had MCL and like the other 95% was a 11/14 translocation so he stayed local and is responding and is happy.

[@beam3819]

What about all the young getting turbo cancers? And other deadly illnesses..TX doctor

[@redbarron6559]

Thank you for this informative video. 🙏🏻💛☀️

[@markhapner8499]

You should respond to Francis Collins' latest NY Times Opinion piece. His 'attack on science' viewpoint on Covid-19 vaccines is a primary example of why faith in the NIH is at rock bottom. There is not one 'scientific fact' he references that would stand up to rigorous scientific review.

[@DrOscarPacheco]

Great advice! But unfortunately, as an old and tired doctor, I think these are battles lost before they begin

[@billyhughes9776]

Thanks Doc -- this is information I will store for possible future use.

[@nicmart]

I remember a study finding that Top Doctors make more errors.

[@sevenmileshome]

I'd be really surprised if a study like that existed. How did they measure error?

[@maxwellkrem2779]

Good video. There is a lot of financial incentive in the $econd opinion business. Not so much the E/M (medical appt) billing but what is called "downstream revenue": imaging, esoteric lab tests, and definitely the pathology overreads. I agree that a second opinion is often helpful, if just to give the patient peace of mind--and I agree 110% that 3rd and 4th opinions only enrich the opining institutions through downstream revenue.

[@HermitBratt]

👏 hats off to you

[@clarkazubuike7265]

Common sense medicine indeed.

[@Mattytube18]

Get 4 opinions. From different same and sectors too.

[@dinahsoar6982]

Thank you for this important information.

[@nancyantonini705]

You are awesome! Thanks for this!

[@goldcountryruss7035]

I need a second opinion on whether a weekly prophylactic standard dose of Ivermectin is actually useful to prevent & treat both viral infections and cancer in an 80YO with COPD. Seems prudent to me.

[@FourthWayRanch]

Ivermectin is for dewoming your dog.

[@poodledaddles1091]

Thanks!

[@gracelynne3918]

It's now safe to assume that ANY medical decision or declaration has at least some financial incentive spurring it along.

[@DiariesByNora]

Literally!!!

[@MP-js5ro]

True story!! Keep calling them out! Are you taking new patients? 🙏

[@uwaviator]

Are they going to kick you out of the club for giving us the scoop dr. Prasad?

[@JJ-hg5ho]

Thanks

[@garrettdyess1110]

1000%. Just saw this happen to a family friend.

[@tayloranderson456]

The reality is the whole healthcare system thrives in an environment where nobody really knows what or who is best or what is effective. That way all doctors can be mediocre or worse but still make good money because nobody really has good info on outcomes or side effects. And the saddest part is usually the financial incentives drive more mediocrity because doctors and hospitals don’t want have real competition like in a pro sport where the best rise to the top. It’s like if you had a pro sports league where the goal was not to win or be the best, but to obfuscate the data the most.

[@omgzfuup]

Not enough resources to do this often in the public system. As a patient I would be willing to pay for a second opinion in many cases though.

[@gstlynx]

Thanks Doc

[@FourthWayRanch]

Where is the trial comparing wegroovey weight loss to just diet and exercise?

[@Rottimom525]

I am waiting to hear if I have endometrial cancer. I had an MRI last Friday, and I'm supposed to get a biopsy. I am stressed beyond words.

[@stealthhumor]

I saw a great cartoon showing a second doctor on the phone talking to the initial examiner. "Oh, she wants a second opinion. What's wrong with her?"

[@nancienordwick4169]

One mm easure of good medical care being used curreis the percentage of patients on statins who have cholseterol over 120. (It shouldn't be a measure!)

[@montanak7]

I can't get any of the local doctors to see me. They've tried to send me to the mayo clinic to the Moffitt center and UF shands. Dr mark Scarborough. Would be great if you need something about him or that Dept of orthopedic oncology in Gainesville Florida

[@attitune]

Interesting that you used multiple myeloma as an example. I know several people who got diagnosed with this since 2021. I'm not sure how many opinions they've gotten before deciding on a treatment plan.

[@brictator]

I only trust Dr. Sbaitso

[@choppyaussemsadventuressta3363]

🙏🏻🙏🏻🙏🏻

[@aptkeyboard3173]

It seems like your audio quality is lower on your recent videos

[@nelsonomicsruns9246]

Medical center rankings are just like university ranking which likewise have Nothing whatsoever to do with quality of education and everything to do with how many meaningless and useless publications their professors have.

[@olibertosoto5470]

So if you're not a doctor, what's a second (different) opinion but more doubt? Well, that's the million dollar question.

[@wcooman1694]

HMOs won't pay for it.

[@thegamejunkie1]

👍

[@jaredkelly5470]

God vid

[@laveraparato258]

I like the new haircut

[@antonpiskernik7824]

I love people with a "good heart"❤- regardless of their external appearance.. [Honest love is really in want nowadays, although being a superb gift from the True God❤]

[@samanthar6172]

Just wanted to let you know that on your video about mask mandates (it came out after this video) KZbin has completely blocked all of your channel information with a giant ad. I can't subscribe to your channel, nor can I see any information about it.

[@anthonybarton2103]

Jay my Cousin Vinny Alex and I didn't it wrong during COVID-19 😊

[@laurabellgia8182]

Nearly all 2nd opinions are just an echo chamber of the 1st dr. Many are done WITHIN the same medical group. Allopathic medicine is group think.

[@beago0810]

Hey, The LIKE button isn't working🤔

[@elvisnnaemeka6722]

😂😂😂

[@seandejesus623]

1st 🏅

[@MartinCymru]

you feel lucky Punck....playing God

[@WORKOUTSOLUTIONS]

✝️ CHRIST IS RISEN ✝️ ❤👨‍⚕️🙏✝ GOD BE WITH US AGAINST EVIL AND TEMPTATIONS ✝🙏⛪️🦾 💍🕊

[@DiscipleofHim]

Welcome back to the channel? How about thanks for tuning in..because a lot of people have never been here. There are new first-time viewers never been here

[@ms-jl6dl]

Someone has a sand in the va*ina.