Getting a Second Opinion

I received a telephone call late last evening from a friend whose wife had been told by her doctor that no more could be done for her back pain,  She remained very uncomfortable and she wanted to know what she should or could do next...

When and how should you go about getting a second opinion—either for yourself or for an ill loved one?

This is one of the most important questions you may face when diagnosed with a serious or chronic medical condition.  Let’s consider this question in two parts:

When is a second opinion appropriate?

·         When you or a loved one receive a life-changing diagnosis.  “Life-changing” does not have to mean life-threatening; you should consider a second opinion whenever a diagnosis would significantly change your quality of life.  For example, if your doctor recommends you go on a gluten-free diet and that entails a drastic change for you, a second opinion is appropriate.  Or, if your doctor recommends surgery and you are at all reluctant, you may well consider a second opinion.

·         When you or a loved one are not responding well to current medical treatment.  Not all doctors are equally well versed on the latest technology and treatment options.  A second opinion can help you discover options, or can reassure you that you are on a good course of treatment.

·         When your current physician cannot find the source of your problem.  In some cases, a physician may perform a battery of tests and report that they cannot find anything wrong.  This can be reassuring news, but it is just as likely to leave you terribly uncertain and frustrated, particularly if you are having persistent symptoms.   A second opinion may lead to decisive diagnosis.

·         Whenever you feel uncertain or uncomfortable with any part of your diagnosis, medical care, or treatment.  If something just doesn’t seem right, trust your instincts and seek a second opinion.

How can second opinions be arranged?

The greatest impediments to seeking a second opinion are:  fear of offending your existing physician; an exaggerated sense of urgency—the feeling that you need to decide on a treatment plan immediately; and not knowing how to go about getting another opinion.

Nothing is more important than your health or your loved one’s health and feeling assured about your diagnosis and treatment plan is key to your health.  Don’t worry about offending your doctor.   Doctors have different views, opinions, and approaches (and often seek second opinions for their own medical care).  If you have been diagnosed by your primary care physician, your condition may well require the opinion of a specialist.  But physicians of all medical specialties fully expect their patients to want a second opinion and are usually more than willing to refer you to another doctor.  Your diagnosing physician can be the best source of a second referral.  If your doctor feels your situation is urgent, he can help expedite your second opinion by getting you a faster appointment with a referred physician.

If you do not want to ask your doctor, you can call another doctor or nurse you trust to seek a referral.  Local hospitals or medical societies also can be excellent sources of referrals.   The American Medical Association’s DoctorFinder referral service can also be helpful.

Also, be sure to:

·         Consult your insurer; a caseworker is usually able to refer to you a second physician under your coverage plan and will explain your benefits.

·         Ask your doctor to forward your medical records to the second physician.   This is a common practice and you need not be embarrassed to ask or feel you are burdening your physician’s office.

·         Meet with the second physician personally.  Never attempt to get an opinion over the phone, email, or Internet.