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International Physician Update
| PHYSICIAN AND PATIENT SERVICES |
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Second Opinion, Please
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| Consulting on cases, second opinion specialist Omar Zidi and internist Don Martin. |
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Internist Don Martin tells the story of a patient from Japan with rheumatoid arthritis. She had no questions about her diagnosis, but she wanted to know why her medications weren’t working. One drug, she said, was causing significant side effects, including diabetes, hypertension and weight gain. Martin reviewed her medications and recommended some newer, less-toxic medicines she was not aware of. “There was,” Martin says, “no reason for her to come here.”
Martin explains that his interaction with the patient was through Hopkins Second Opinion Service for international patients. In some cases patients have an established diagnosis and are exploring treatment options outside their home country. Or, their diagnosis and recommended treatment are so serious that they want to have it confirmed by another physician before undergoing treatment.
“It’s either a diagnostic dilemma or a therapeutic dilemma or a lack of response to therapeutics being given at home,” Martin says.
Such cases are triaged through second opinion specialists like Awad Aziem, who review up to 100 of these cases each month. Rather than asking patients to travel to Baltimore to be evaluated at sometimes unnecessary expense, these second opinion specialists ask that patients or their referring physician send medical records, lab results and imaging studies to Hopkins for specialists like Martin to review. The consulting physician will then evaluate the case and determine whether therapy or surgery can make a difference.
For Korean physician K.H. Rah, who referred his mother to the Second Opinion Service, the process was a simple one. “We sent my mother’s hospital records to Johns Hopkins International, and they in turn sent all of their results and recommended treatment plans back to her physicians in Korea,” Rah says. “So it was a second opinion for both her and her doctors.”
Whether such patients should come to Hopkins depends on whether the medical center can offer a treatment or surgery not available in the patient’s home country. Aziem cites the case of a pediatric cancer patient from Europe. Looking at her medical records and imaging studies and the dire diagnosis they supported, he doubted she could be cured. But after sending the patient’s file from his office across campus to an oncologist, he learned that a bone marrow transplant offered hope. The patient had the treatment and, six months later, says Aziem, her doctors reported she was in good health.
“Surprisingly,” says Aziem, “the outcome was 95 percent successful.”
“In most cases,” says Martin, “we’ve been able to give patients and their physicians at home some additional therapeutic options.”
“Hopkins can be on the edge in many different cases,” adds second opinion specialist Omar Zidi. “We can make a difference in the correct treatment for the patient.”
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