That’s when it’s time for a second opinion. But broaching the subject before signing up for the recommended treatments is intimidating for many. It requires standing up and asking a professional for time to consider someone else.
Although it’s supposed to be nothing a professional can’t handle, many doctors are consumed with the righteousness of their opinion and may be offended. They may question the need or dismiss it in a way that makes the patient question the decision.
In any event, it’s saying no, even temporarily, to the recommendation of someone who literally may hold the power of life and death in their hands.
Particularly in the cases of serious diseases like cancer or heart disease, delaying treatment also could have life-threatening implications. But in murkier cases in which what’s ailing the patient may not be so clear-cut, getting a second opinion can provide valuable input and reassurance for the course of action.
The Value of a Second Opinion
The Mayo Clinic conducted a survey on the impact of second opinions. In a review of 1342 abstracts and 41 articles, that survey found that second opinions typically confirm the original suggestions for a treatment regimen or diagnosis. However, 10 percent to 62 percent of second opinions yielded a major change in the prognosis, treatment or diagnosis, with a larger fraction of patients receiving different advice in the second opinion than the original diagnosis.
Patients seeking a second diagnosis were motivated to seek one for confirmation of their potential treatment options, dissatisfaction with a consultation, a genuine desire for more information, original treatment complications or persistent symptoms even with treatment.
Because there are few studies on patient-initiated second opinions, how accurate a second opinion was in diagnosing a successful treatment path is unknown. In general, though, the Mayo Clinic favored getting a second opinion, citing that a new or different diagnosis and treatment advice had value to the patient. The Mayo Clinic said the second opinion provided either reassurance that the original diagnosis or treatment suggestions were correct or offered an alternative.
Patient Rights
Many patients receive their diagnosis in somewhat of a fog or state of shock, particularly if the news is bad and confirms their worst fears. That leaves them ill-prepared to ask the right questions of a doctor who may not have much time to spend with any individual patient.
But patients are entitled to make an informed decision about their care, and while certain emergency situations – such as the aftermath of an accident or an aneurysm – may not leave time for a second opinion, keep in mind that you do have the right to understand the diagnosis and treatment options. And the right to participate in selecting a treatment by making your desires known to the doctor exists.
Of course, cost is also a factor. Some insurance companies may not cover the second opinion, and keep in mind that Medicare doesn’t pay for procedures or surgeries that are not deemed medically necessary, such as cosmetic surgery, and, therefore, won’t pay for a second opinion on them, either.
How to Ask for a Second Opinion
The first step in getting a second opinion is to ask your current doctor if he can recommend a colleague. While you may hesitate to go to someone who has ties to a certain doctor, it’s often OK with the first physician. You also can ask another trusted doctor if there is a recommended physician for your condition, or ask the local medical society for a list of those near you who treat your alleged condition. An online search can help locate an appropriate contact.
The first doctor will need to send medical records to the doctor providing the second opinion to avoid duplicating tests that have already been completed. Follow up with the second doctor’s office before your appointment to make sure the records arrived.
It is a good idea to bring a friend or relative along on the second opinion visit. This not only provides support, but also gives you a second set of ears and the ability to have other questions answered that you may not have considered. Always write down a list of questions for this second appointment. Like the first visit, although you are still in a foreign environment and may be shocked at the diagnosis, you at least will have a plan and won’t have to fumble for the right questions at the moment.
For the second opinion, it’s good to have a list of prior tests completed (even if they are the medical records) and specify any surgery being considered. This saves valuable time for the doctor and allows him or her to grasp your concerns and considerations instantly.
If Opinions Differ
If the second doctor provides a different diagnosis, you’re left with a quandary – which opinion is more valid. A third, or even a fourth, doctor visit is warranted if you feel you need more information. Again, it’s your body, your time and your money, and if more information is needed to make an important decision, then do so.
Some patients return to their original doctor and discuss the second opinion. This may open up new avenues for consideration in the original doctor’s choices, and he or she may often suggest getting one more opinion to make absolutely sure of the correct path.
A 2006 study of Michigan breast cancer patients discovered that more than half were advised to change course on treatment plans after having their case reviewed by a multidisciplinary tumor board comprised of medical oncologists, surgeons, radiation oncologists, pathologists and radiologists. Most cancer centers and some hospitals have a tumor board that reviews certain complex or challenging cases and recommends treatment options.
Keep in mind that even highly qualified and super-skilled doctors can make mistakes or differ in how to approach treatment. Judgments can be made quickly and often by several people who may look at a slide or X-ray in different ways.
Ultimately, patients must make the call on what they will and will not allow. While that may require a great deal of courage, getting reassurance on the right treatment path is worth the minor embarrassment or hesitation.