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.
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:
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.
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."
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."
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:
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.
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.
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.
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.
RESOURCES:
Agency for Health Care Policy and Research
http://www.ahcpr.gov/consumer/surgery.htm/
Health Care Choices
http://www.healthcarechoices.org/
CANADIAN RESOURCES:
Canadian Health Network
http://www.healthcarechoices.org/
Health Canada
http://www.hc-sc.gc.ca/index-eng.php/
References
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 November 2009 by Brian Randall, 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.
Copyright © 2007 EBSCO Publishing All rights reserved.