Is it okay to get second (medical) opinions here?

I have been going to a dermatologist for a year because of my skin condition. She was rather jumping to prescribing a drug I am very wary about, so I had asked to rule out other treatments before resorting to that strong drug. She agreed and we tried other things. However, one year later and I am back to where I was.

I sought another medical opinion because I knew we had exhausted the options with my original dermatologist. The second dermatologist also advised to take that strong drug, but I was not very impressed with her as she tried to sell me her studio's own skincare line of 8 products "for a very special price if I was paying cash on the spot". This 2nd dermatologist prescribed me a battery of lab tests to check my hormones, and she said to consult with my gynecologist - which I did - and to come back. I didn't want to come back to her as I didn't like the sale attempt.

Instead, I did the labs and went back to my original dermatologist with the lab results in hand. She asked who had prescribed those, and I said the gyno after I sought a second opinion. It seems my answer upset her, and I wasn't happy with the service I got. It seems she prescribed what the other dermatologist suggested, rather than what she would have prescribed.

I thought it was a form of flattery saying I went elsewhere but I liked/trusted her best. However, it seems my remark went the opposite way.

In Italy it is pretty common to seek a second and a third opinion before taking important medical decisions, and I don't understand why this doctor was upset. A local friend said that here some doctor do not like to have their authority questioned.

Now I don't feel supported in this new treatment with the strong drug, but I don't want to waste one year of work with my original dermatologist.

Thoughts? Especially from Rice whose husband is an MD!

Quote from Splinter

What's COPD?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.

See this NHS page for a layman explanation. Basically, if you are a long time smoker with silver hair, you have some sort of breathing issue that would classify as COPD.

Both my parents are heavy smokers, and they surely have it. My father is getting checked for other heart issues and may have received a formal diagnosis, although he will never tell. My mother avoids going to the doctor.

When I stay at her place, I can hear her coughing and whistling in her sleep from the other side of the apartment. The first time it happened, I thought she was about to die and couldn't sleep myself. Then I understood this is just how she lives and breathes. Ouch!

Quote from UK Man

Seems all a bit OTT to me but she knows much better than me how things work here.

You never know what classes they may have skipped!

Are these doctors through your insurance or do you go there privately, UK Man ? Here doctors are paid very little by insurance providers (like 3-4 USD per visit), therefore they are overbooked and try to squeeze in too many patients. Not to mention, that they make you go there as many times as possible so that they get paid more - the more the visits, the more the money.

As a result, you will end up spending hours in waiting rooms, whereas very little time is actually spent with the doctor. Plus, he/she will forget about you the minute you walk out the room.

My husband's grandpa used to heavily tip the doctor. It seemed to work to reinforce that he could afford a better service and expected to receive a silver lining treatment.

Carrot and stick never fail... perhaps. This system is so broken that sometimes it seems people do not care about money, yet they complain they do not have/get enough.

Quote from bebopalula

serafina how much flexibility does your obera social/prepago/whatever give you over choice of medical resouces? For instance if you wanted, would they pay for you to see a consultant in a teaching hospital or a specialist in one of the big, well-regarded hospitals?

There are two kinds of doctors in my prepaga (Hospital Italiano):

1) Those working directly for the Hospital Italiano - can be Central location in Almagro, the other hospital they have in San Justo, or one of the smaller clinics in Belgrano, Barrio Norte, Olivos, San Isidro, Caballito and other locations too far for me. Some of these also work in medical teams and perform surgery when required. Sometimes it just seems they are attending at the hospital premises, but not full time. As if they were running their own practice, but renting the office space of the hospital.

2) Then there are doctors who are affiliated with the prepaga, i.e. have their private practice and will offer services also through prepagas in their own premises. They are paid very little and affiliated with more than one prepaga.

Some of them work solo, some work also at hospitals and in teams, and teach.

100% of the time they visit in an apartment that works as a doctor studio.

This skin doctor that has been following me since 2022 works both at the HI hospital in San Justo (I suppose as part of a team, because she knew my previous dermatologist who left HI), and visits at the HI clinics in Barrio Norte. She rarely has a spot available at HI, unless there is a cancellation. Currently, the first available with her through the HI, is in late May-early June. It is impossible to get a monthly appointment with her for checks through the HI. I should be booking now to start seeing her monthly beginning 5 months from now, and wait for the booking to open for July in a few weeks. It is not like you can simply book a monthly check starting in 30 days.

In any case, it was just random that she work at the HI, as I simply booked with her at a private skin clinics that opened 4 block from my place. There are 5 dermatologists, 3 cosmetologists, and a nutritionist. She was the first available dermatologist when I was looking for an appointment. During our introductions, I mentioned that I was being previously followed by a dermatologist of my prepaga -- she mentioned that she also works at the HI and knew her.

In any case, my remark was that I was surprised of her attitude when I mentioned that I had sought a second opinion. To me, it is to be expected and not a sign of distrust.

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On a tangential note, we are very disappointed with the Hospital Italiano since it is virtually impossible to be followed by a doctor. It is either the lack of appointments or the crappy compensation that creates a quick staff turnover. Just last week my gynecologist informed me that he will be stopping working at the Hospital Italiano. I have had him for 3 years and it is the longest I went with a gyno at HI. In 9 years with the HI, I must have seen 6 gynecologists. Lucky for me, I just have an annual checkup. If I had an actual health issue, it would be impossible to be followed long term by a single physician.