Broker Check

Second Set of Eyes

| November 18, 2020

Second Opinion can be thought of as a Second Set of Eyes for the Medical Field.

In general I consider it TMI to discuss my own medical situation in public, even with individuals I know well much less on a blog post. But, in this case, I'm hoping this discussion will be helpful maybe even instructive.

I digress. I have / had multiple undergrad college roommates and multiple siblings-in-law who are now MDs. Students of psychology, genetics and maybe personality might determine some cause & effect in this. I have considered it and might be another post at another time. Or, maybe more below

Back to part of my own medical story. I have OSA. Obstructive Sleep Apnea. Since approximately 2002 and I use a CPAP machine every night all night.

Shifting gears quickly, when I moved to Rhinebeck I did not have a PCP - primary care MD. I found one whom I feel is excellent and have recommended him to others. (He might not even be accepting new patients any more.) He is part of a large multi-specialty medical group with multiple offices in multiple counties. When I first met my MD and discussed my history, I asked him for a recommendation for a Sleep MD in his group. Sadly, he knew of no one he felt comfortable recommending. So I searched elsewhere and ended up using a sleep MD associated with the (Weill) Cornell Medical School in New York City.

Also unfortunately even after working with that MD for a couple of years I was ongoing unhappy with the quality and amount of my sleep. So I inquired further and found another Sleep MD at the same Weill Cornell Medical Center.

Wow! I'm glad I did.

In my very first (Zoom virtual tele-medicine) meeting with my new Sleep MD, she gave me several recommendations and things to try and proactively told me to follow up with her in 2 months, which I have already scheduled.

I just did a brief mental count. She is my 6th Sleep MD. And she mentioned a number of things I had literally never heard before. (And a couple of repeats.) And she even said she has more but she didn't want to overwhelm my on my first try.

How can this be possible?

(Hold that question.)

In medicine, there are some measurements that are objective. Blood Pressure. Blood Sugar. Height & Weight. Cholesterol. Age. etc. Since I am a "pro-science" person (but not actually a scientist) I understand that it is possible for certain measurements to be taken objectively. Different folks might define that differently. I'll just say that with a measurement tool that has been checked and properly calibrated, there should be no change in the measurement when a different person - operator - does the measuring.

But now is when it gets interesting - where the rubber meets the road, so to speak ....

What is the "Best" course of action given a particular set of measurements?

This, of course, is a horse of a very different color. Even if there could be hypothetically 2 patients with the exactly same 6 measurements mentioned above (e.g. theoretically possible with identical twins,) when we begin to add other factors, it essentially becomes impossible to compare two different people. Other than prisoners, almost certainly no 2 people eat the same. And even with twins it would be unlikely they would exercise identically. Not to mention other lifestyle factor and other health conditions.

Ironically, as we dove deeper into the situation, the comparison with someone's Financial Plan / financial condition becomes a stronger, not weaker comparison. And even if we add another objective measurement, I'll press my thumb on the scale and choose Retirement Age or Retirement Date, the comparison between any two (or more) people still stays complex. We have all their other financial facts.

  1. Income now.
  2. Income in retirement.
  3. For self and spouse.
  4. Social Security for both.
  5. Possible pension for one or both.
  6. Retirement accounts
  7. Non-retirement accounts
  8. Home(s)
  9. Other investments / real estate / non-financial.
  10. Oh, and what about their Values?
  11. And Risk Tolerances.
  12. And family situation.
  13. Children's needs.
  14. Grandchildren.

Fiduciaryness. Professionalism. Science, Logic & Objectivity. Experience. Training.

Many years ago I read an article somewhere that was attempting to compare financial "folks." The author put together a few Case Studies and asked multiple Financial Folks to make recommendations. The author was  .... surprised .... shocked ... (!) to discover that multiple financial folks would make differing analyses and recommendations from a common set of facts. Actually, that is completely UNsurprising. IMPO. In My Professional (second) Opinion.

So, as mentioned in the heading above, depending on  the "Fiduciaryness," Professionalism - and experience - and training and professional education - if you do decide to have a Second Set of Eyes look at your Financial Situation you will (I predict) see something different than what you have. Maybe better. Maybe worse. But almost assuredly different. And probably not trivially so.


  1. This may sound ridiculous, but needs to be said. I have, can and continue to do Financial Plans. But I don't do them for free.
  2. Also, and this is a bit less obvious. I accept a new client if (and only if) I determine that I can add value for that client in a fiduciary manner.
  3. These two points have led me to the post linked below - a No Charge Phone Conversation for a potential client. Read more. Feel very free to call and discuss, without charge or obligation.

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