2nd opinion

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Why seek a second medical opinion?

 

You do not need to seek a second opinion if you are in complete agreement with the diagnosis and treatment options your doctor has discussed with you.

However, when you are diagnosed with cancer, it is normal to feel overwhelmed and confused. You may have doubts about the accuracy of the diagnosis, or you may find it difficult to choose between the treatments your doctor has suggested. Or you may wonder if there are other options for treating the cancer you have.

A second opinion can confirm that all the necessary tests have been carried out and that the results have been interpreted correctly.

Hearing what another doctor has to say may help you feel better and make your decisions more confident.

RCP

 

What is RCP?

The RCP brings together health professionals from different disciplines whose expertise is essential to make a decision that provides patients with the best possible treatment according to the state of science. During the RCP, patients’ files are discussed in a collegial manner. The decision taken is documented, submitted and explained to the patient. Decisions may concern any aspect of a case:

♦ Establishment of a diagnostic strategy,

♦ Validation of diagnosis,

♦ Establishment of an initial or secondary management strategy,

♦ See palliative strategy decision.

How to set up a CPR?

There is a strict legislative framework for cancer PCRs.

Firstly, it is important to set clear objectives for the PCR so that participants are assiduous and the PCR is sustainable.

Here are the main elements to be specified:

Title of the CPR : it will define the domain of CPR.

Definition of stakeholders :

  • A coordinator who organises and facilitates meetings,
  • Doctors representing each specialty necessary for the multidisciplinary nature of the RCP: medical oncologists, radiotherapists, organ specialists, internists, etc.
  • Other health professionals involved in the patient’s care: psychologists, physiotherapists, social workers, nurses, etc.

Definition of the frequency of meetings 

Definition of the selection criteria for the files studied :diagnostic, therapeutic or teaching interest to the community for example.

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The RCP brings together health professionals from different disciplines whose skills are required to adopt the individualised management proposal best suited to each patient, according to assessable quality criteria. These quality criteria are the national recommendations if they exist, and the recommendations and guidelines of learned societies.

It records the therapeutic plan envisaged for each cancer patient under care, as well as any significant changes in therapeutic orientation.

It was made compulsory by Article 31 of the 2003-2007 Cancer Plan, in all health establishments, groups of health establishments, cancer networks or in the context of cancer coordination. This is one of the technical conditions for the operation of the cancer treatment activity. The only exception concerns clinical situations that are the subject of standard management of indisputable validity: in this case, the therapeutic project is implemented without waiting for the RCP.

It is mentioned in article D. 6124-131 of the public health code. In November 2017, the HAS drew up a “Multidisciplinary consultation meeting” sheet.

The RCP can also be organised, on an optional basis, in specialities other than oncology, particularly for complex treatments (multiple sclerosis, bariatric surgery, etc.).

Who participates in CPR?

 

The coordinator establishes the list of patients whose files are to be analysed and notifies the members of the PCR (permanent staff and referring physician).

The diagnostic or therapeutic RCP must be attended by at least three doctors from different specialties who work with cancer patients, to ensure a relevant opinion on all the procedures envisaged.

If one of the specialists whose presence is required is missing, the case must be presented again at the meeting as soon as possible.

The patient’s treating physician may attend, but is not required to be present.

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