When and How to Get a Second Opinion
Jack, a 50-year-old office worker, discovered a small lump on the side of his neck. He scheduled a visit with his primary care doctor, who examined the lump and ordered tests. When the tests results were in, Jack's doctor explained that though benign, the lump was what he called "pre-cancerous." His treatment options were to closely monitor it but do nothing else now, or to surgically remove the lump.
Explaining the pros and cons of each option, the doctor stated that in his opinion the best option was to remove the lump via surgery. After asking his doctor a number of questions, which he answered in depth, Jack said he would like to take a few days to think about what to do. His doctor agreed and suggested that he consider getting a second opinion. In Jack's case, the second opinion confirmed the impression of his primary care physician.
When to Get a Second Opinion
What if your doctor doesn't suggest that you seek out a second opinion? How do you determine whether your situation warrants a second medical opinion?
It's virtually never a bad idea to seek a second medical opinion, unless your condition is life threatening and requires immediate emergency medical attention. In many circumstances, seeking a second opinion is not only warranted, but necessary. These circumstances include anytime the following occurs:
- A medical condition or problem is considered serious.
- Surgery is one of the treatment options suggested.
- Numerous possible treatment options are available.
- After consulting with your doctor, you still have a number of unanswered questions.
- You're told by the doctor that a specific type of treatment cannot be used to treat your condition.
- You're told by the doctor that nothing, or nothing more, can be done to treat your condition.
- Following treatment, your condition recurs.
- A cause for your symptoms is not found, but the symptoms continue.
- You feel that there is something "wrong" with the diagnosis or suggested treatment for your medical condition.
Never Too Late
What if you begin receiving treatment, and then decide that you'd like to get a second opinion? Is it too late? Although it's best to seek a second medical opinion soon after a condition or problem is diagnosed, it's never too late, even after a course of treatment (with the exception of surgery) has begun.
Why Bother With a Second Opinion?
A second opinion can help you better understand your medical condition, answer any outstanding questions, remove any doubts, help you weigh the plusses and minuses of the recommended treatment options, and help you make an informed, educated decision as to what treatment is best for you.
Because medicine is not an exact science, and many conditions can mimic the symptoms of other conditions, diagnosis can be difficult. As a result, getting a second opinion can be integral to making certain that the original diagnosis is correct.
Dr. Jerome Groopman, professor of medicine at Harvard Medical School and author of the book, Second Opinions, feels there can be another important benefit to asking for a second opinion.
"It causes me," says Dr. Groopman, "to wonder whether I failed to fully communicate with him my thoughts and my understanding of his condition. His question about a second opinion may be his way of saying that I need to reopen our dialogue, to listen again, more carefully, to his words."
Getting a Referral for a Second Opinion
Generally, you should first ask your doctor for a referral. In most cases, a reputable physician will welcome this request. But like many patients, you may feel uncomfortable and uncertain about asking your doctor for this type of referral. A 1999 Los Angeles Times article suggests you word your request in the following way: "You know, this is a complicated and important issue for me, and I think I'd like to talk to another physician about my diagnosis. Perhaps you have a recommendation?"
The bottom line is that if the circumstances warrant a second opinion, be sure you get one. Dr. Groopman explains, "Often a patient and his family hesitate to ask if a second opinion would be beneficial because they fear they will insult the doctor...that the question will be misconstrued as a threat and alienate their caregiver, who might then abandon them out of pique. This should never occur. A patient and his family should never hesitate to seek more advice and counsel."
Getting a Second Opinion on Your Own
If you find yourself on your own and needing to do some research as to whom you might call for a second opinion, you can do so by doing the following:
- Calling local hospitals, medical centers, or medical schools and asking for a referral to a specialist who works at or in connection with that facility.
- Checking the American Medical Association's American Medical Guide and by checking the Directory of Medical Specialists (a reference guide that lists only board certified physicians who have passed certain comprehensive examinations).
In addition, before going to see any doctor for a second opinion (especially one you find on your own), check that doctor's background and training. Most state medical boards can supply you with that information, and some states have made that information available on the Internet.
Will You Have to Pay for a Second Opinion?
The cost of a second opinion depends on your health care provider or insurance plan. Before scheduling an appointment for a second opinion, check with your insurer to see if they cover second opinions, and if so, what restrictions are in place. Some health plans require a second opinion, and will pay for it in full. Others will pay for it if you seek a second opinion from a specialist within their health care or insurance network. Even if you find yourself having to pay out of pocket, remember that a second opinion might save your life. Although costs can vary greatly, a second opinion consult will generally cost between $150 and $650.
Will You Have to Repeat Diagnostic Tests When Seeking a Second Opinion?
While most doctors will want to conduct their own examination (and may order additional tests), in most cases, they will be able to use the data (i.e. X-rays, CT scans, blood tests, etc.) that have already been collected to evaluate your condition, verify or disagree with the original diagnosis, and suggest the treatment option they feel is best suited to your condition.
To minimize wasted time and wasting resources, make arrangements to hand deliver test results, X-rays, and any other appropriate information—including copies of your medical record—to the second opinion doctor before the day of your appointment.
If You Get a Second Opinion, Can You Still Get Treatment from Your Original Doctor?
It's your choice (subject to any limitations by your health care provider or insurer) to seek treatment from your original physician, the physician who provided the second opinion, or from another physician altogether.
Agency for Health Care Policy and Research
Health Care Choices
BC Health Guide, British Columbia Ministry of Health
Canadian Health Network
Groopman J. Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine. Viking Penguin Group; 2000.
Mestel R. Need a second opinion?. Los Angeles Times. February 15, 1999.
Questions to ask your doctor before you have surgery. Agency for Health Care Policy and Research website. Available at: http://www.ahcpr.gov/consumer/surgery.htm.
What to do if cancer strikes. Cancer Research Institute website. Available at: http://www.cancerresearch.org/hbstep2.html.
Last reviewed January 2008 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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