‘That doesn’t line up. She wasn’t even listening to me.’

How do you get a second opinion in an already strained healthcare system?

Donna Schreder had almost given up on getting another opinion for her condition.

Last July, the Yellowknife resident developed a skin infection. She doesn’t have a primary healthcare practitioner and, when her condition didn’t get better, she sought help through same-day appointments and emergency room visits over the months that followed.

On several occasions, she was sent home from the emergency room with different antibiotics to try. Her condition did not improve.

Schreder described this as feeling like a can being kicked down the road, offered medicine after medicine each time.

During one visit, a locum doctor told her they thought she needed surgery and ordered a CT scan.

In November 2024, needing emergent care, Schreder went to the ER again. A surgeon told her she didn’t need surgery after all because they couldn’t see any infection on her CT scan.

The surgeon gave her a printout of what she thought Schreder had. Schreder, reading it, felt that none of the symptoms on the printout matched the ones she had.

“That doesn’t line up,” Schreder recalls thinking. “She wasn’t even listening to me.”

Schreder felt the diagnosis wasn’t correct and wanted another doctor to look at her case.  

She remembers the surgeon that night leading her to believe that if she sought a second opinion within the NWT healthcare system, it would be no different to the one she had just been given.

While Schreder happened to have an appointment already booked the next day with another surgeon – and decided to keep it – she arrived the next morning to find the appointment had been rebooked for later in the day. Not only that, it was now with the same surgeon she had seen the day before.

“I had just given up at this point,” Schreder said.

Her sister, who was with her, happened to have a personal connection with someone working at the surgery desk and had the appointment moved to a different surgeon.

That second surgeon did, in fact, offer a completely different second opinion: Schreder needed surgery. She underwent emergency surgery the next week.

The outcome

Only through that surgery, Schreder said, did healthcare workers discover she had a serious infection that responds only to one specific, strong antibiotic.

She is now recovering, though the infection had progressed for so long that she says there have been complications in her healing and aftercare. She has had months of daily home care, receiving antibiotics intravenously alongside care for the surgical wound. Since March, that home care schedule has dropped to once a week.

To Schreder, it’s “frightening” to think about what might have happened if her sister wasn’t with her that day and able to advocate for her.

“Who knows what the outcome could have been?” Schreder said.

She worries about other people she sees going through similar things in the healthcare system, especially those who are older or may not speak English.

“If I can’t advocate for myself through that system – and you know, I’m pretty good at advocating for myself, for the most part – I don’t even know the struggles that others might face,” Schreder said.

How do you get a second opinion?   

The NWT’s healthcare system has its fair share of issues, including high vacancy rates for both local family physicians and specialists alongside difficulties for patients in accessing primary care.

In a system already trying to cope with these challenges, how does someone go about getting a second opinion if they aren’t wholly satisfied with their initial diagnosis?

In an email, an NWT health authority representative wrote that there is no “one-size-fits-all answer to this, unfortunately.”

“Depending on the medical concern, the patient may need to return to the Emergency Department for follow up, at which point they could speak with another physician,” the authority representative stated.

“In other cases, a follow up or second opinion could be warranted through primary care, at which point the patient could ask to book an appointment with another health care provider.”

Asked whether any patient can request a second opinion if they want one, considering issues such as wait times and persistent staffing shortages, the representative said “patients have the right to advocate for their health, including seeking a second opinion.”

Patients don’t have to share their reason for booking an appointment and are entitled to an appointment time when one becomes available, the representative said.

Though Schreder had her sister to help, not everyone has that option or a personal connection to someone who can help them navigate the system.

There is, however, some patient advocacy built into the NWT’s healthcare system.

The Office of Client Experience, or OCE, is described by the health authority as a group of patient advocates who can help to navigate the system and ensure people receive culturally safe, equitable care to help deal with the impact of illness. 

Even so, it’s unclear how easily this is accessed in practice – and it seems to fall on patients to know the OCE exists and contact that office if they need help.

The importance of second opinions

The Canadian Medical Association’s code of ethics and professionalism, physicians are obliged to “respect your patient’s reasonable request for a second opinion from a physician of the patient’s choice.”

The association’s website notes that “second opinions are a normal part of medicine” and, ideally, “the second opinion should not be closely linked to your first doctor.”

Requesting a second opinion shouldn’t cause issues with your physician. The Canadian Medical Protective Association – a not-for-profit that helps physicians with legal defence and liability protection – states: “The fact that a patient seeks a second opinion should not be interpreted as a breakdown in the doctor-patient relationship.”

Getting a second opinion can be beneficial to help a patient understand their diagnosis or make a more informed decision about their care, according to the CMA. 

Research also suggests that patients who seek out a second opinion have improved care outcomes.

A 2017 study from the Mayo Clinic, published in the Journal of Evaluation in Clinical Practice, found that up to 88 percent of patients who sought a second opinion received a new or refined diagnosis.

In the study, only 12 percent of patients who asked for a second opinion received confirmation that the original diagnosis had been complete and correct.

If a second opinion helps a patient receive a more accurate diagnosis, that can prevent unnecessary treatments and get them appropriate care more quickly – which could be lifesaving in some cases.  

Continuity of care

Schreder said her case also highlights the need for greater continuity of care.

“It seemed like there was so much confusion from doctor to doctor,” she said, and with each doctor she saw, “so much time” was lost to simply going through her files.  

She doesn’t blame the people working in the system. “I don’t think it’s their fault. I don’t think there’s a lot they can even do,” Schreder said.

“I heard a lot of frustration coming from the healthcare workers themselves, too, with just how broken the system seems anyway.

“I even got that impression from the doctors at the clinic, where they’re just like: ‘Well, I can’t even follow up with you, so what can I do?’”