When To Get A Second Opinion

We tend to think of doctors as experts--that's why we trust them. But even doctors can make mistakes, and sometimes physicians disagree on diagnoses or treatments. So why do so many people unquestioningly follow their doctor's advice?

Let's say you see a doctor who proclaims this on your next visit: "You need lots of drugs and invasive surgery to treat your diagnosis. It's risky, expensive and there may be side effects. Of course, there's no guarantee it'll fix what ails you, but my recommendation is you get to the hospital right away." What now? If you're like the majority of Americans, you'll do exactly what your doctor says, without blinking an eye.

According to a 2005 Gallup poll, fewer than 50 percent of Americans seek second opinions when their doctor diagnoses a condition or prescribes a treatment, drug, or operation. Forty-one percent "sometimes" seek second opinions, while just 3 percent "always" seek one. Why is that?

Part of the reason may be that some people don't want to offend their doctor or worry about repercussions in future visits because they've questioned their doctor's advice. Some see care providers as authority figures and feel intimidated by them. They may be worried it'll cost too much to see someone else, or they're just scared and want their doctor to do whatever it takes to fix them.

In contrast, most doctors want patients to get second opinions, and many health insurance providers require them before they authorize treatments. Dr. Melinda Muller, Senior Medical Director of Primary Care at Legacy Good Samaritan Hospital in Portland, Ore., says: "Patients worry they'll hurt our feelings if they request a second opinion. Nothing could be further from the truth. We want patients to get all the information they need when making critical decisions."

Here are some situations in which you may want to seek a second opinion:

• Whenever your diagnosis or proposed treatment plan is complicated, risky, speculative, has long-term consequences, serious side effects, or there are a variety of treatment options.
• If surgery or an aggressive treatment approach is recommended and there are other, less-invasive treatment options.
• If your diagnosis requires a specialist, or you feel your doctor's area of expertise doesn't cover your situation.
• If you prefer a more integrative or non-pharmaceutical/surgical option.
• Any time you feel your goals don't match your doctor's, or if your doctor isn't giving you enough information.
• If something just doesn't feel right. There are many stories about people who followed their intuition and discovered they were misdiagnosed or mistreated.

Where do you get a second opinion? Your first diagnosing physician may be the best person to start with when looking for a second opinion. The doctor can refer you to specialists they've worked with before. On the other hand, some experts recommend seeking second opinions from physicians and hospitals with no connection to the original diagnosing physician to get the most objective viewpoint.

Here are some additional tips for getting a second opinion, according to The National Women's Health Information Center:

• Ask someone you trust for a recommendation. If you don't feel comfortable asking your doctor for a referral, then call another doctor you trust. You can also contact university teaching hospitals and medical societies in your area.
• Ask to have medical records sent to the second doctor. Make sure your primary care doctor sends your medical records to the new doctor.
• Learn as much as you can. Ask your doctors for information. Find out which books, websites, or other resources they recommend. Go to a local library, search the Internet, and find a teaching hospital or university that has medical libraries open to the public.
• If you don't understand something, ask. Make a list of your questions, and bring it with you when you see your new doctor.
• Phone a friend. If you're having a bit of anxiety about that second doctor visit, bring along a friend or relative who's good at asking questions and/or can keep you on track to find out what it is you need to know.

Be sure to check your coverage before you get a second opinion. If you find a provider you want to see, use Provider Search to determine if the doctor is in your network. Call the number on the back of your card and find out what your next steps are.

A fresh perspective may confirm your diagnosis and treatment plan. However, it may also provide other options and even prevent malpractice. Studies show second opinions result in dramatically different treatment plans in 30 percent of cases. Surgical recommendations change in more than half of breast cancer cases, according to a 2008 study in the journal Cancer, put out by the American Cancer Society.

Whatever you do, be proactive. Tell your doctor you want more information before making medical decisions. Request copies of test results and consultation notes. Contact your hospital and ask about patient advocates to guide you to the right resources. Consider getting an online consultation with a specialist at a large teaching facility. Take your healthcare seriously--and make sure everyone else does, too.

Reprinted with permission from myRegence.com