Perhaps you have been diagnosed with something as serious as cancer or something less serious such as a torn rotator cuff. You might trust your doctor—and his/her diagnosis—completely. But what if you don’t? Perhaps you want a second opinion—to explore other treatment options or just to confirm your original doctor’s diagnosis and treatment plan.
You might feel awkward about asking your doctor if you should get a second opinion…but the truth is, doctors are asked about second opinions a lot more often than you might think. And under many circumstances, you might not even need to tell him/her in advance.
Sometimes insurance companies make it easy for you and mandate a second opinion before a procedure is covered, but even when it’s your choice, getting one can help you better understand your condition and treatment options. This is especially important if the proposed treatment comes with serious side effects and/or potential long-term consequences…or there are new treatment options available. Example: If you seek a second opinion from a specialist at a major medical center known for treating your problem, you may have access to newer therapies or clinical trials…or you may find alternatives to surgery.
There are even more compelling reasons to get a second opinion…
Your condition is life-threatening or life-changing. The more serious the medical problem, the more valuable a second opinion. This is particularly true if you have cancer or an autoimmune disease—severe illnesses that require a lot of nuance and complicated therapies.
Many forms of cancer are treatable if you get the right diagnosis and prompt treatment. Research published in Annals of Surgical Oncology that focused on patients with breast cancer found that a second review by a multidisciplinary tumor board at a National Cancer Institute–designated center changed the diagnosis in 43% of cases and that translated to more accurate treatment.
Second opinions also can be valuable for noncancerous conditions. A study at University Medical Center in Utrecht, the Netherlands, published in PLOS One found that over half of patients with internal-medicine issues, such as abdominal pain, fatigue or weight loss, who asked for a second opinion received a more complete diagnosis and 13% got a new diagnosis. For many of them, a new medication was started and symptoms improved.
You’re unsure about the first doctor. You should have faith in your primary doctor’s opinion. But if you don’t, seek a second opinion.
Your doctor suggests a radical procedure. A second opinion can help you evaluate invasive treatments, such as surgery, and those with potentially serious side effects, such as going on a biologic drug that can alter the immune system.
Your condition has not improved after three to six months. If you expected your condition to improve but it hasn’t, you should question whether the diagnosis or treatment plan is flawed.
There are alternatives to the proposed treatment. It is easy to understand why you need treatment if you have a torn rotator cuff or significant degeneration in a knee joint and your doctor shows you the problem on imaging tests. But in some cases, there may be nonsurgical alternatives that can yield the same or better results. Surgeons tend to be biased in favor of surgical solutions. Consider practitioners who take a conservative approach such as physical pain specialists and physiatrists.
There’s no rule that says you must disclose to your original doctor that you’re getting another opinion…and trampling on any doctor’s ego should not be your primary consideration. Also, keep in mind, doctors often consult with other doctors to form their opinions.
You may be able to access your medical records on your own from your health-care system’s patient portal. Print them, and bring them to the new doctor. For images of radiology tests, you often can get a copy from the facility where the tests were done. Keep in mind—even if you provide all your records, the second doctor may need to do follow-up tests.
If there’s no way to get your records other than to inform your existing doctor, you might say, “I respect your opinion but want another opinion because my health is at stake” or if the diagnosis is more serious, “…my life is in jeopardy.” If your doctor has a problem with that, you might question his motives.
If your first diagnosis was from your primary provider and you’re looking for a specialist’s opinion, consider asking your primary for a referral. Your care could involve a collaboration, and you’ll want everyone on the same page.
Whether you need surgery or nonsurgical treatment, take the following steps…
Check to see if your insurance limits you to providers in its plan or if you can cast a wider net. Example: You might be able to look out of state at major medical centers that have cutting-edge techniques.
Use all the tools available to you, from word of mouth to online research, to look for doctors who have extensive experience with your health issue.
Check to see how many times any doctor has performed the procedure and whether he has written or lectured about it. If you can’t find the information you want online, contact the doctor’s office manager to ask questions about the doctor’s practices.
Note: Doctors within the same institution but not within the same practice office should be unbiased in their opinions, but if there is only one specialty practice in your area or affiliated with your local hospital, you might want to find a doctor in another health network who is also covered by your insurance.
Having similar opinions can strengthen your trust in your original doctor. But when opinions differ, answers to key questions can help determine which direction to go. Ask the second doctor…
• What led you to this conclusion?
• Why is this treatment better than my original doctor’s treatment?
• What outcome can I hope for based on research and the doctor’s experience?
• Is the latest therapy available?
For a non-life-threatening issue, you might feel more comfortable choosing a less aggressive approach, such as physical therapy rather than surgery. But for a cancer diagnosis, get the fullest explanation possible for the new opinion so that you can compare it with the one given by your initial doctor.
Of course, it’s possible to look for a third opinion—sometimes fourth or fifth opinions with rare and unusual or “orphan” diseases—but you’ll have to weigh the pros and cons of the delay in treatment that this will cause.
