Options for remote medical second opinions..

March 3, 2012 10:35 AM

Internet / phone based medical OB/GYN second opinions. Any decent options? Good idea/bad idea?

My partner is 16 weeks pregnant. We live in a small island nation with about 5 OB/GYN's, only one of which we trust (ours). We have other special snowflake problems, which our OB/GYN has gone above and beyond to assist us with, and we have a very good relationship with them. We do however have a concern over falling progesterone levels, which although our OB/GYN has answered in detail for us, their response is not giving my partner enough comfort and she wants a second opinion on this very specific question. We fully intend to keep using our OB otherwise.

Given use of one of the other OB/GYNs on island is out of the question (genuine horror stories from friends) our options are 1. a time consuming and expensive international trip to another country for a second opinion (possible but painful), or 2. Remote consult via phone or Internet.

We have used phone consults for a very specific medical question previously, where the selection of a remote doctor for the consult was easy (very specialized field) and it worked well, but I'm struggling to find a decent option for an OB/GYN remote consult. Any recommendations/advice?

I fully expect the remote consult will confirm the advice of our OB/GYN, but if not, we have the option for progesterone supplementation, which our OB/GYN is okay with - but doesn't think is necessary in any way. Although a remote consult obviously means no physical, we believe the question here likely can be answered by case history review and the results of blood tests - both of which we can provide.

We don't necessarily want to ask our Dr for a referral for a second opinion for very special snowflake reasons, as well as not finding any other local OB an acceptable alternative for referral.

posted by anonymous to Health & Fitness (2 answers total)

I fully expect the remote consult will confirm the advice of our OB/GYN, but if not, we have the option for progesterone supplementation, which our OB/GYN is okay with - but doesn't think is necessary in any way.

Not really an answer to your question, but if this is the issue than will your OB/GYN just prescribe the supplements even if he thinks they're useless? They can't hurt, though medical professional are divided as to whether they help or do nothing.
posted by amro at 10:50 AM on March 3, 2012

I fully expect the remote consult will confirm the advice of our OB/GYN

IANAD but I'm not sure a second opinion will actually get you anything but a divided opinion. A large percentage of doctors do not do progesterone supplements or even test levels after 14 weeks because progesterone production has been taken over by the placenta so the view is that maternal supplementation doesn't actually do anything except possibly make pregnant women feel better when freaked out. There is no unity of opinion on whether supplements in the 2nd and 3rd trimester is a good thing, a neutral thing or even a negative thing. Conditions caused by low progesterone in the 2nd and 3rd tri like cervix issues can be treated, though. Possibly your mutual time is better invested in knowing what you will do if any of the conditions that can arise to threaten miscarriage or pre-term labour actually arise (or don't arise.)

If your partner is willing to say "Progesterone supplements will make me feel less powerless" and your OB is willing, I am not seeing an upside to a 3rd opinion here. Otherwise, I'm not really sure what you're asking.
posted by DarlingBri at 12:42 PM on March 3, 2012 [1 favorite]