· Features

A second opinion may avoid long-term sickness absence for the employee and save money for the employer

Misdiagnosis is, understandably, a highly stressful situation, but it isn't just individuals and their families that can be affected. A clinical failure to detect an underlying medical condition can also have a financial impact for an employer, and the lost skills and talent of a highly experienced employee can have a knock-on effect on colleagues and the overall team performance.

The potential cost of misdiagnosis to business is significant according to available data. US studies show that patients get the wrong diagnosis as much as 20% of the time and the wrong treatment half the time. A 2009 Healthcare Commission Report, for example, analysed over 9,000 complaints and concluded that almost one in 10 related to either a delay in diagnosis or the wrong diagnosis being made. 

So, what can employers do to minimise the occurrence of misdiagnosis among their workforce? And what are the potential benefits to their business?

Offering employees the opportunity to seek ‘second opinions' from world-renowned medical experts has been one solution increasingly adopted by employers. It's a solution that sounds expensive but in practice need not stretch the corporate budget. It can be obtained as a standard insurance policy benefit and, using modern communications technology, is, in most instances, free at the point of use.

For the employee, it provides an expert review of their medical diagnosis and treatment plans, and ensures they get the best possible advice. For the employer, it means being able to improve the quality of healthcare offered to their employees and their families and to demonstrate they are serious about their health. This puts employers in a stronger position as they prepare to take advantage of an economic recovery and look to attract and recruit the best talent.

A second opinion service can also deliver significant cost benefits to employers and be particularly effective alongside an absence management programme. By helping to ensure that medical conditions are correctly diagnosed, employees can be comfortable they are on the right rehabilitation path, private healthcare costs can be reduced by the avoidance of unnecessary or inappropriate treatments, and a positive contribution can be made to a faster return to work. 

In situations where there may be an issue with health insurance coverage, a second opinion can help to resolve differences of opinion between the consultant leading the patient's treatment and the insurance company that is funding the treatment - avoiding stressful delays in treatment.

Chartis has seen a number of cases where misdiagnosis or mistaken prescription could have had a detrimental impact on the employee and resulted in significant time off work had they not taken up the opportunity to seek a second opinion.

A man aged 43, was diagnosed with a brain tumour (Ewing's Sarcoma). Before undergoing chemotherapy, he asked for a second opinion, a service provided for by his employer. His file was sent to the US and immediately reviewed by a professor and a specialist pathologist in sarcomas. As a result of the review the team in the US requested urgent further tests and it was found that the man did not have a brain tumour, but had suffered a stroke - saving him from unnecessary treatment and risk to his life.

The issue of mis-prescription is highlighted by another case involving a female teacher. This teacher had a challenging class of 11 year-olds. She felt stressed and began to get stomach pains. After being admitted to hospital for tests, she was given medication for the pain. A week later all her tests were negative but her pain was increasing.  A second opinion was sought and although they could not diagnose the reason for her pre-hospitalisation stomach pains, they said the increasingly severe pains in hospital were caused by a dangerous clash between medication she was taking for epilepsy and the medication the hospital had prescribed. Two days after coming off the hospital medication she was pain-free and returned to work.

Second opinions ensure patients receive a comprehensive analysis of their situation and treatment options and avoid mistakes in circumstances where their choice of treatment may be one of the most important decisions they ever make. Any medical decision should be based on the most complete and reliable information available to maximise the chances of a full and faster recovery.

And, in a business world where employees can make the difference that persuades a customer to choose one company over another, it makes commercial sense to ensure that they and people close to them have easy access to a second opinion service.

Paul Dobinson is head of commercial underwriting, accident and health at Chartis