HoW WE SELECT EXPERTS FOR each client
We select a panel of 3 to 10 (and more) international experts whose research and clinical interests precisely match your medical situation. We search medical literature, programs of medical conferences, we consult our global expert network to select perfect experts for each client. Our reach is unlimited: we use the entire global universe of academic physicians and surgeons to avoid bias in view on diagnostic pathways and treatment methods.
Learn more about our Method:
We live in a precision medicine era. It means a condition that just recently was considered a single entity actually consists of many different subtypes, each with its own optimal treatment and outcome.
We are free to select our experts anywhere in the world.
Our only criterion is how precisely a specialist fits the exact medical situation you are facing. That’s all we care about. We are not restricted when selecting experts by any clinic, hospital, university, city, region, or country, or continent. No one has a monopoly on medical knowledge. No hospital or clinic in the world has all the best experts for all situations.
We always start with the analysis of information you transmit to us. Then we search medical literature to find a list of experts who are most active in research and innovations in your particular medical condition.
We review their publications and identify key focus areas of their true expertise. We scout leading medical conference websites for presentations and summaries of the latest medical research in your specific diagnosis.
We also share a short summary of your case with suitable experts in our extensive global medical network. It has several thousands of world’s leading physicians. We listen to their ideas and leads to identify those experts around the world who are best positioned to solve your medical conundrum.
Once we have a long list of suitable potential experts who precisely match your medical situation, we reach out to 5 to 10 such experts. We get feedback from these specialists on key aspects of your case and on how suitable they think they are to review your situation in detail.
Based on all that research and information we assemble an expert panel that reviews your entire case.
Moreover, each expert on the panel studies your situation independently of other experts. This ensures objectivity which is not affected by existing relationships between experts, because all leading experts in any speciality mostly know each other for decades.
We integrate everyone’s feedback and we cross-examine every view and opinion. Then we present all our findings to you in a detailed written report, with relevant medical references. For details of our Process, see the video about our process of working with a client.
HOW WE WORK ON YOUR CASE
The result of our work on your case is a comprehensive written report. It discusses all expert opinions and contains references to relevant research papers. You will receive a full explanation on how and why we selected specific physicians or surgeons to review your situation. We have zero conflicts of interest in all our decisions.
- Send us key data and tell your story.
No bureaucracy. No need for all records.
- We prepare your case for expert panel.
We structure data and present your story.
- We prepare your Client Report.
30-80 pages, 50-150 reference links.
- We answer all remaining questions.
We include 1-3 years of follow up.
Learn more about our Process:
We believe in minimal bureaucracy. We don’t make you gather all your medical records or fill out numerous forms. We focus on the most relevant information and the results of key diagnostic studies.
We always provide hyperlinked references to primary sources of clinical research articles that experts used to make their recommendations on diagnostic and treatment options. So you will know where every opinion is coming from and what formed the basis of expert advice.
We follow a structured process to ensure efficient and personalized service. All interactions are done via asynchronous communication (email and messengers). We complete most cases within 5 business days.
We take six steps to complete the work on your case:
Step 1: We advise you if you have sufficient information for a review of your case by a panel of top experts in your specific condition. Typically we check for completeness of information with a relevant specialist. If you need to gather additional diagnostic information, you can complete additional diagnostic tests at any location convenient for you. You can then transmit the results to us electronically.
Step 2: We start with a review of available medical data you shared with us. We can help you to identify and obtain the most relevant information. You can share your information with us via secure encrypted file exchange services. If translation into English is required, we can do a translation for many common languages.
Step 3: We structure your diagnostic information and your clinical story into a well-organized written ‘case’. We do so exactly like doctors summarize a patient’s story at any hospital. We then present your case and the results of diagnostic tests to an international panel of top experts whose qualification, research, and clinical interests perfectly match your specific medical situation. Please see a separate video about our Method of selecting and working with expert panels.
Step 4: A panel of three to ten experts reviews your situation and makes suggestions on additional diagnostic steps and treatment options. We usually have several follow-ups with all specialists who work on your case.
We seek to clarify suggestions of our experts. We cross-reference different opinions because all experts review your case independently of each other. Sometimes they do review your case as a team. This happens when different specialists are involved in a multi-modality treatment, such as surgery, chemotherapy, and radiotherapy for cancer.
Then we incorporate expert views and suggestions into a comprehensive written report. Our report includes additional information that helps you understand the background, context, and implications of expert panel recommendations.
With us, you do not simply receive a “dry” one- or two-page letter from a doctor, as is typical for most second opinion services. Our report provides extensive and expertly curated background information that is relevant for your situation. Any medical opinion should be taken in a context of all existing alternatives. Our report provides you with such context.
Step 5: We transmit a written report to you via secure encrypted electronic transfer method. After you review our report, we provide you with an opportunity to ask us follow-up questions. You can do that via email or web teleconference or any messenger.
We will answer all your questions and provide follow-up on the same topic. Length of the follow-up period depends on the category of service you select. We always encourage you to share our report with your primary medical team.
Step 6: We delete all your data after you have had an opportunity to ask us questions. All your data is deleted approximately one month after we transfer our expert opinion report to you. This is the best protection of your privacy.
HOW TO APPROACH ANY MEDICAL PROBLEM
7 Questions to ask in any medical situation
Medical problems differ, but there are common decisions to make in any medical situation. These are seven questions you should ask whenever you encounter a medical problem:
7 Questions (click for details)
Question 1. What is the meaning of my diagnostic tests?
Any abnormal test requires confirmation. You have to be certain that the results of all diagnostic tests are real and meaningful. All diagnostic information must be analyzed together, fully, and without confirmation bias. Confirmation bias is when you interpret the data to favor your existing hypothesis.
Question 2. Is my diagnosis correct, precise, and complete?
Research shows that initial diagnoses are frequently incorrect: For example, 65% of cases presented to experts for medical second opinion were originally misdiagnosed or mistreated. 40% of elective surgery cases were deemed not necessary when reviewed by specialists. Effective conservative treatment was possible.
Diagnosis could be correct, but not precise enough. This is how many clinical trials fail. For example, patients with same general diagnosis are given a drug. In reality, there are, say, three groups that differ by some aspect of the correctly diagnosed disease. The drug helps one group, it is useless for another, and it harms the third. When you lump the results together, it shows the drug does not work. Yet that conclusion is not correct – doctors simply failed to detect meaningful differences between the patients within a broad diagnostic group.
Precision medicine today can pick up many subtle but important nuances between patients with the same general diagnosis. Pharmaceutical industry is not always keen on detecting these subtle differences in patients. “Thanks for turning my billion-dollar drug into a million-dollar drug”, one pharmaceutical executive said to a precision medicine expert at a medical conference.
Diagnosis could be correct but incomplete. For many heart conditions, a particular anatomical or functional measurement of how the heart adjusts to disease could predict which treatment will work best, and which therapy should be avoided. But some patients are not alerted by an astute physician to the necessity of doing these diagnostic tests. Therefore, they may choose treatment options with less clarity.
You may be certain that your diagnosis is correct and your treatment is optimal. But a review by a diverse panel of international experts – who see thousands of cases exactly like yours – is still useful. Precise expert panel opinion will provide you with additional confidence that you are following the correct path back to health.
Question 3. What is the most likely progress of my condition?
If you research prognosis and response to treatment for most diagnoses, you quickly realize that the gap between “best” and “worst” scenarios is enormous. So, which scenario of the disease progress applies to you? How different treatment options can change your prognosis?
Question 4. What treatment options work best in my particular situation?
“P4 Medicine” is already here: Personalized, Predictive, Preventive and Participatory. Precision medicine certainly presents many new options for treatment. But it also demands a better understanding of nuances of diagnostic and treatment options. Patients and families must be able to weigh complex tradeoffs between an increasing array of therapeutic methods and modalities.
Question 5. Which risk factors can make my condition worse?
Any disease is an interaction between “nature and nurture”. Genetic, environmental, and behavioral factors affect progression of every medical condition. How to decrease the influence of negative factors? How to enhance every positive influence from your body’s internal healing powers, and from the environment around you?
Question 6. What does medical research literature say about my condition?
Is there data from recent medical research that might already benefit my treatment but that might not yet be known or accepted into practice widely?
Superior treatment methods for your condition may already exist somewhere. But it’s possible that most of the world keeps doing “old stuff” despite those innovations.
This situation is more common than many realize.
For example, a new method of rectal cancer surgery decreased recurrence rates from 40 percent to 5 percent. It was developed by a British surgeon in late 1980s. But it took twenty more years to spread the use of this superior surgical method around the world.
A minimally invasive heart valve surgery method was developed in mid-1980s by a French surgeon. He worked in a small town 100 miles from Paris. He did the first surgery in humans in 2002. But it took another 15 years for his method to become the standard of care in minimally invasive heart surgery today.
What are the recent research breakthroughs for your condition? Are there new therapeutic methods that might affect your treatment plan today?
Question 7. Does my condition have implications for others in my family?
It is well known that actress Angelina Jolie had extensive genetic testing after her mother died of ovarian cancer at 56. Her grandmother died of ovarian cancer at 45. Her mother’s sister died from breast cancer at 61.
Breast, uterine, prostate, and ovarian cancers have overlapping genetic risk factors. Proactive genetic testing can identify family members at risk before clinical symptoms of advanced disease appear.
The list of diseases with strong genetic influence grows every day. So is our understanding of the meaning of these complex genetic associations. Which genetic tests are right for you? How do you interpret them?
When medical disasters happen, people are always shocked. But few people take steps to prevent medical catastrophes. That is true even when preventive measures are well-known and cheap, and when it is possible to act many years before a disaster strikes. Be confident in your diagnosis and treatment. Your health is in your hands.