Dr. Ajesh Raj Saksena


A lady in her late thirties walks in to my outpatient today for a 2nd opinion. Battling breast cancer for the last 7-8 months, having completed chemotherapy and breast conservation surgery, she notices increasing swelling in the affected breast while on radiation therapy. A needle test and further PET CT evaluation uncovered the grim reality of a large recurrence in the affected breast with disease spread to the pelvic bone within such a short span of ongoing treatment to their disbelief.

In the wake of this devastating news, a lot of doubts questions arose in her mind.. Questioning whether the earlier doctor had done the right treatment for her? Adding to the fact that her treatment was done free of cost, whether the treatment have been compromised?

As I listened to her concerns, it was evident that she anticipated me to unearth some flaws in the earlier doctors treatment, perhaps even criticize the care and treatment done to her so far.. In my opinion, the entire treatment had been done by the book, meticulously executed, adhering to established medical guidelines, and following the best practices in the cancer care. In all honesty, I saw no apparent fault in the choices made, and I realized that, faced with the same situation, I would not have offered any other course of treatment..

While the lady found comfort in my agreement, I couldn’t shake the disheartening trend we observe more and more in modern day practice — the increasing tendency for patients to seek multiple opinions and doubt the medical decisions made. It is troublesome, as we lament the loss of the days when doctors were consulted with unwavering faith..

Reflecting on her concerns, I understood that this growing distrust might partly stem from the inherent complexities of medicine. While the majority of patients respond positively to standard treatments, there are cases where outcomes differ, despite the most diligent efforts of healthcare providers. The unique nature of each individual’s disease biology and responses to treatment add layers of uncertainty and unpredictability.

The way forward to address this distrust lies in an open communication and transparency between patients and doctors. Taking the time to explain treatment options, potential risks, and “realistic outcomes” can empower patients to make informed decisions and strengthen the doctor-patient relationship. Additionally, encouraging patients to seek second opinions can be viewed not as an insult to their primary doctor’s expertise, but as a means of gaining more information and exploring alternative perspectives.

Ultimately, navigating through the complexities of healthcare requires collaboration, empathy, and trust on both sides. As we continue our medical practice, I am reminded of the profound responsibility we bear in caring for patients, not just physically, but emotionally and mentally, as they embark on their unique journeys towards healing and hope.

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Disclaimer: The views and opinions expressed in this article, “The ‘Second Opinion’ by Dr. Ajesh Raj Saksena, are solely those of the author and do not represent any specific medical institution or organization. The information provided in this article is intended for general informational purposes only and should not be considered as medical advice or a substitute for professional medical consultation, diagnosis, or treatment.

Dr. Ajesh Raj Saksena

Dr. Ajesh Raj Saksena

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