Get a Second Opinion

Virtual Second Opinion • How To • Costs • Disclaimer • Consent Letter
Informed Consent • Records Release Form • Excluded Location
In-Person Consultation

Santa Monica Thyroid Diagnostic Center
Virtual Second Opinion

The Santa Monica Thyroid Diagnostic Center offers state of the art online thyroid consultations for distant thyroid patients unable to travel to see Dr. Guttler.

You will not be treated as just a "consult", but as a living, breathing human with a thyroid problem.

Dr. Guttler will personally deal with your problem. He will write you, or your doctor if you wish, an opinion after review of all the medical records and laboratory results. He may ask for blood to be sent to his thyroid laboratory to continue the investigation into your thyroid problem. He may need to see the actual slides from a thyroid needle biopsy or thyroid surgery slides.

Unlike big impersonal centers with online consultation services staffed by hundreds of physicians, such as John Hopkins, Cleveland Clinic, or Massachusetts General, Santa Monica Thyroid Diagnostic Center is a small private complete thyroid center, where Dr. Guttler does all the consultations personally. Dr. Guttler’s staff includes the same nurse, front office, and office manager for over 13 years. The lab director, Dr. Carole Spencer, has run the thyroid lab since 1974. Experienced, friendly staff is needed to allow Dr. Guttler to efficiently help you work through your thyroid problem. It also says a lot about Dr. Guttler, as an employer, that his staff is not turning over frequently.

Do I Need a Virtual Second Opinion

Should I pursue a radioactive iodine treatment? Will the therapy recommended by my doctor address my problem fully? What are my treatment options? These and many other questions are common if you, or someone you love, have a thyroid illness.

When faced with a difficult decision, it is usually helpful to gather other points of view. Often a second opinion can provide reassurance that a prescribed treatment is best or it can be a safeguard against inappropriate or unnecessary treatment.

When it comes to your health and well-being, confidently understanding your condition and options is a crucial first step in pursuing what is best for you. Now you can access a second opinion from one of the nation’s best thyroid physicians, in the comfort of your home, through Thyroid.com.

What is Thyroid.com Virtual Second Opinion?

Thyroid.com Virtual Second Opinion is a web-based extension of the Santa Monica Thyroid Diagnostic Center, with thirty years in business as one of America’s most respected thyroid referral centers, and providing thyroid consultations and second opinions using the internet since 1996.

Why was Thyroid.com Virtual Second Opinion established?

Today patients, especially those in high-stress situations, making decisions about treatment for themselves or a family member are actively seeking reliable information and knowledgeable guidance. The Santa Monica Thyroid Diagnostic Center historically has been a resource for physicians and patients seeking thyroid second opinions, and the internet gives us a channel to continue fulfilling that role.

What is the key benefit for patients who use Thyroid.com Virtual Second Opinion?

Thyroid.com Virtual Second Opinion provides patients with convenient access to a nationally recognized thyroidologist for a second opinion without the time or expense of travel.

How will the patient’s privacy be protected?

Thyroid.com, the Santa Monica Thyroid Diagnostic Center and the Virtual Second Opinion service adhere to the highest standards of privacy. Patient information will be sent in written form to the patient rather than over the internet.

What are typical next steps after obtaining a Thyroid.com Virtual Second Opinion?

Once a written second opinion is obtained from Dr. Guttler, the patient has many options:

1. They may visit Dr. Guttler at the Santa Monica Thyroid Diagnostic Center for a complete in-depth one-to-two day evaluation, where the complete thyroid physical examination will be performed.
2. Patients may proceed to the treatment that was originally recommended by their own physician.
3. They may ask their physician to consult with Dr. Guttler or other specialist, or they may decide they want to seek another opinion or arrange for another physician’s visit. Also, Dr. Guttler may recommend a thyroidologist nearer to the patient’s home.

What differentiates Thyroid.com Virtual Second Opinion from other sites and physicians offering second opinions on the web?

The Thyroid.com Virtual Second Opinion differs from other internet second opinion portals in that the program goes beyond reviewing slides and studies to provide the kind of detailed thyroid consultation second opinion patients receive in person at the Santa Monica Thyroid Diagnostic Center. The Santa Monica Thyroid Diagnostic Center is a one-stop complete thyroid center offering radioactive treatment, thyroid scans, thyroid biopsies, and thyroid cancer treatment – so that the patient can have a complete evaluation within one or two days in most cases. The same attention to detail is given in our virtual second opinion service since 1996. At Thyroid.com Virtual Second Opinion, patients are not just consults, they are formally registered at the Santa Monica Thyroid Diagnostic Center. They are treated similarly to patients who have physically come in to the Santa Monica Thyroid Diagnostic Center and their records become a formal medical record at the Santa Monica Thyroid Diagnostic Center. A nurse is available to our Virtual Second Opinion patients, and she will contact every patient who receives a second opinion to make sure that all of their questions have been answered. Also, Dr. Guttler reviews the original materials such as x-rays, MRIs and pathology slides, rather than copies. In addition, when possible, our service provides the second opinion directly to the patient, which gives the patient complete privacy and autonomy. Upon request, a second copy can be sent to the primary physician.

Is the Thyroid.com Virtual Second Opinion available to everyone?

The Virtual Second Opinion program is available in most locations. Patients may access the Virtual Second Opinion service directly through thyroid.com. In some states, to comply with state licensing requirements, the patient’s physician may need to sign a request for outside consultation form. This form is presently online to the patient. Once the form is signed and returned to Santa Monica Thyroid Diagnostic Center, the patient will work directly with us to complete the Virtual Second Opinion request. The program is not available in a few states that do not allow for remote consultations. Patients who are in those states will be notified that the service is not available to them. Please click the "Excluded Locations" navigation button or click here for list of excluded states and countries.

After viewing the other information pages linked to the navigation buttons in the navigation bar to the left and you still have questions, please call:

1-800-408-4909

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How does Thyroid.com Virtual Second Opinion work?

The patient contacts Thyroid.com via the Thyroid.com website. The patient then submits medical history information and answers questions specific to their thyroid diagnosis. The patient then gathers information pertinent to the diagnosis from their local doctor, hospital or lab, such as pathology slides, blood tests, x-rays, CT scans, etc., and mails the originals to the Santa Monica Thyroid Diagnostic Center. The Thyroid.com website has a records release form that can be used to obtain the slides, lab and hospital records, or doctor records to be sent to the Santa Monica Thyroid Diagnostic Center. Dr. Guttler thoroughly reviews the medical history and the original tests before rendering his opinion. The patient will be notified in writing to ensure security of medical information.

Instructions for Sending Pathologic Slides

After filling out a records release form and with actual pathology slides released from a hospital or a pathology lab to be sent to the Santa Monica Thyroid Diagnostic Center, follow these basic instructions:

In order to expedite clearing of pathology and biopsy slides from transport into the country through U.S. Customs, if you are coming for a second opinion or sending a second opinion from outside the country, please be sure to include the following statement on the courier air bill:

"Pathology slides of non-infectious, non-contagious human tissue. This specimen has never been cultured. It is for review by the Pathology Department of the Santa Monica Thyroid Diagnostic Center, Santa Monica, California, U.S.A. It has no commercial value."

Blood Mailer Kit

The blood mailer kit is used for sending a blood sample for definitive thyroid testing at Santa Monica Thyroid Diagnostic Center laboratory. The kit includes a prescription for having the blood drawn, a tube which is a Vacutainer blood tube that has plastic beads to stabilize the blood sample until it arrives at the Santa Monica Thyroid Diagnostic Center for testing. The blood does not need to be frozen or spun or in any way handled other than to be drawn into the tube. This blood container kit will be able to preserve the blood in any condition from very cold climates to very warm climates without freezing. Just have the laboratory or doctor draw the blood into the Vacutainer blood tube, pay him for the venipuncture, place the Vacutainer blood tube in the soft pack mailer, place the mailer in a FedEx pack and send to the Santa Monica Thyroid Diagnostic Center with this disclaimer on the air bill:

"Medical blood sample that is non-infectious, non-contagious. The specimen has never been cultured and is being sent to the thyroid laboratory of the Santa Monica Thyroid Diagnostic Center, Santa Monica, California, U.S.A. It has no commercial value.

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How much does a Thyroid.com Virtual Second Opinion cost?

A Thyroid.com Virtual Second Opinion costs $495, payable at the time of the request with a major credit card or check. If pathology reading of original pathology slides is required, there will be an additional $150 fee. If it is necessary to obtain a blood sample for special thyroid testing at the outstanding Santa Monica Thyroid Diagnostic Center laboratory, the fee is $150 for the blood testing via the Thyroid.com blood mailer kit. Blood testing by the mailer kit can only be performed in states where it is allowed for blood to be drawn and sent to another lab outside the state.

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Thyroid.com Virtual Second Opinion Service Disclaimer

By using the Virtual Second Opinion service offered by the Santa Monica Thyroid Diagnostic Center, you agree to abide by the terms and conditions posted on our Virtual Second Opinion website at www.thyroid.com, including particularly the terms and conditions described below. The service provided through our website, Thyroid.com is different from the diagnostic services typically provided by our physician, Dr. Guttler. Providing this service will not have the benefit of information that could be obtained by examining you in person and observing your physical condition. Therefore, Dr. Guttler may not be aware of facts or information that would affect his opinion of your thyroid diagnosis. To reduce the risk to you of this limitation, we strongly encourage you to share the second opinion with your physician or come to see Dr. Guttler personally at the Santa Monica Thyroid Diagnostic Center. By deciding to engage this service, you acknowledge and agree that you are aware of this limitation of the Virtual Second Opinion service and agree to assume the risk of this limitation.

By requesting a second opinion pursuant to this website, you acknowledge and agree:

1. That the diagnosis you receive is limited and provisional without a physical exam, and
2. A second opinion is not intended to replace a full medical evaluation of a face-to-face visit with Dr. Guttler. Dr. Guttler does not have important information that is usually obtained through a physical examination. The absence of a physical exam may affect Dr. Guttler’s ability to diagnose your thyroid condition. By engaging Dr. Guttler’s services, you acknowledge and agree to assume the risk of these limitations. You further understand that no warranty or guarantee has been made to you concerning any particular result or cure of your condition.

Consent Letter

Consent letter to patient’s physician inquiring on whether he/she will allow patient to be referred for a virtual thyroid second opinion at the Santa Monica Thyroid Diagnostic Center. Click here for print friendly version of this Physicians Consent letter

Santa Monica Thyroid Diagnostic Center
1328 16th Street • Santa Monica CA 90404
Phone: (310) 393 8860 • Fax: (310) 395-8147
Outside California: (800) 408-4909

Dear Referring Physician:Patient's name: __________________________________________________.
Your patient has indicated an interest in a Virtual Second Opinion at my Thyroid.com Santa Monica Thyroid Diagnostic Center website. The patient will not receive a consultation directly from me, as my second opinions are provided by mail. You can agree to refer your patient, and we will report to you in writing. If you agree to your patient's request for a second opinion, you may submit your patient's history and related materials by mail. After receiving a complete medical history, patient's payment and related materials, my opinion will be mailed to you.
Please note, payment for services is the responsibility of your patient and is unlikely to be covered by his or her insurance.
If you agree to refer you patient, as he or she has requested that we obtain your approval, please sign below and mail or fax to us at:
Santa Monica Thyroid Diagnostic Center, 1328 - 16th Street, Santa Monica, CA 90404. Fax number: 310-395-8147.

Physician Name: __________________________________________________
Physician's Signature: ______________________________________________
Date: ___________________________________________________________

If you have any questions, call us at: 1-800-408-4909

Very truly yours,
Richard B. Guttler, M.D., F.A.C.E.
Director of Santa Monica Thyroid Diagnostic Center

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Patient Informed Consent

Your physician will require that you acknoledge and sign this form for a Virtual Second Opinion from Dr. Guttler and his Santa Monica Thyroid Diagnostic Center.
(Click Here for a printer friendly version.)

Patient's Name: ___________________________________________.
As your treating physician, I am able to arrange a physician consultation organized through the internet from Dr. Richard Guttler, Director of the Santa Monica Thyroid Diagnostic Center, at www.thryoid.com. I believe you may benefit from information I learn through such a thyroid consultation. In order to help you decide whether you want to agree to this, I would like to explain how the consultation works.

Consultation Arrangement

With your permission, I will submit your records including your name, address, date of birth, nature of your thyroid condition, related thyroid history, thyroid scans, and ultrasounds to Dr. Guttler. If needed, I will provide additional information to Dr. Guttler. I will send this information by mail. Dr. Guttler will provide me with a written report of his findings and recommendations. I will review the report as your treating physician and contact you to explain the options suggested and recommendations by the thyroid consultant. Because you requested this consultation, it may be only an indirect relationship between Dr. Guttler and yourself because this is mainly directed as a physician-to-physician thyroid consultation on your behalf.

Confidentiality

Dr. Guttler and his staff will use your medical information to consult with me and will keep this information confidential in accordance with applicable laws. Your medical information will be seen by only Dr. Guttler and other authorized individuals of his staff. The patient information I submit and the report from Dr. Guttler will be part of your medical records I maintain. Dr. Guttler will also keep a copy at the Santa Monica Thyroid Diagnostic Center.Patient's Signature: _____________________________________________________
Date: ________________________________________________

Physician Name: _______________________________________
Address: _____________________________________________

(Click Here for a printer friendly version.)

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Virtual Thyroid Consultations Excluded Locations

Please be advised that the Thyroid.com Virtual Second Opinion service is unavailable in the following states and countries. The excluded states, territories and countries are:

American Samoa, Federated States of Micronesia, Guam, Iowa, Louisiana, Maine, the Marshall Islands, the North Mariana Islands, Oregon, Pilau, Puerto Rico, South Carolina, Tennessee, and the Virgin Islands. The excluded countries are: Cuba, Iran, Iraq, Korea, Democratic Peoples’ Republic of North Korea, Libya, Sudan, and Syria.

In-Person Consultation

Three good reasons why you should come to see Dr. Guttler at the Santa Monica Thyroid Diagnostic Center or obtain a Virtual Second Opinion from Dr. Guttler:

1. Dr. Guttler actively participates in medical research with the U.S.C. Thyroid Research Group headed by Dr. John T. Nicoloff, Carol Spencer, Peter Singer and Jonathan LoPresti.
2. Dr. Guttler has 30 years experience in performing thyroid procedures, including needle biopsy, thyroid scans and ultrasounds.
3. Dr. Guttler will perform all the studies on you personally, as he is involved in every aspect of your care during your visit to Santa Monica Thyroid Diagnostic Center.

The Santa Monica Thyroid Diagnostic Center receives patients and virtual second opinion requests from all over the world. It has received patients from Africa, Asia, the South Pacific, Canada, Europe, Latin America as far away as Brazil, and the Middle East, from Dhubai to Saudi Arabia. All the services available to patients in the United States are available to the rest of the world with a concentrated, short visit to the Santa Monica Thyroid Diagnostic Center. All the testing equipment, blood testing, lab and biopsy are available under one roof for a rapid, one-day complete evaluation so that you can either return to your home country or go on tour or vacation in the United States.

Travel Information

The Santa Monica Thyroid Diagnostic Center is in the Los Angeles area in the small beach city of Santa Monica. It is approximately ten miles from Los Angeles International Airport (LAX). LAX is the main airport you would fly into from anywhere in the world except for local traveling from cities such as San Francisco, in which case there are multiple smaller hub airports such as Burbank and Long Beach that can be your entry into Los Angeles, but most international travelers or national travelers will be coming through LAX. Los Angeles International Airport is approximately a $15-20 cab fare to the Santa Monica Thyroid Diagnostic Center.

Accommodations

Once you have decided to visit the Santa Monica Thyroid Diagnostic Center for a one-two day complete evaluation, we can assist you with local accommodations. We are glad to make short- or long-term lodging reservation in the Santa Monica area suited to your needs. We can obtain reduced rates at some of the local hotels. To make lodging arrangements, please call us if you have any questions or visit our website area, where we list rental cars, hotels, and airplane reservation websites.

Guest Services

Once you have decided to visit the Santa Monica Thyroid Diagnostic Center, we will assist you with travel and lodging arrangements related to your visit. If you are traveling from a foreign country, away from family and friends, this can be stressful. We can help make your stay more relaxing and enjoyable. We can make restaurant reservations, help you with plane tickets, local entertainment and sports venues, a list of websites for Santa Monica and Los Angeles, local museums, theme parks (Disneyland), etc.

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