Sometime in their lives almost everyone faces a serious medical situation for themselves or a family member. When faced with a diagnosis that could have serious implications it is natural to feel fearful and maybe confused. Medicine is not an exact science. Tests can be uncertain and there can be alternative treatments for the same condition. A second medical opinion can help you make informed decisions and may even save a life.
When should you seek a second opinion?
In an interview with WebMD, Jerome Groopman, MD, author of Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine says you should get a second opinion “any time you have a very serious or life-threatening disease:
- Where the treatment is very risky or toxic.
- Where the diagnosis is not clear, the treatment is experimental, or there is no established consensus or Food and Drug Administration-approved treatment.
- If you're considering participating in a trial for a new drug.
- If you're considering some new experimental approach or a procedure that involves using experimental instruments or devices.”
Even for non-serious conditions you should consult another physician:
- If something is clearly affecting your health and well-being, but your doctor can’t pinpoint a cause.
- If you believe your doctor is not taking your symptoms seriously.
How do I make it happen?
You do not need your doctor’s permission to get a second opinion, but asking them for a referral for a second opinion is often the best path forward. By enlisting your doctor’s participation, it can make it easier to transfer medical records and test results. If you prefer to have a new doctor start with a blank slate you can try connecting with others who have had the same diagnosis. Support groups for your specific condition can be a good source of referrals for specialists.
Will this affect my relationship with my doctor?
This should not be an issue. Second opinions are a common and routine part of medicine. Most doctors welcome another set of eyes to look at a problem. If it feels awkward to ask, the Center for Advancing Health suggests saying something like this: “You know, this is a big decision for me, and I would like to talk with another expert or two so that I feel completely confident in our treatment plan.”
Who pays for a second opinion?
Nearly all insurance providers including Medicare will pay for a second opinion, but you should do your homework and check with your provider first to confirm this. Also your insurance company may have specific procedures they want you to follow in getting your second opinion. For example: they may require prior authorization and/or the use of a plan-approved provider.
What do I do if the outcome is two medical opinions that are significantly different?
“If the second doctor agrees with the first, you can feel more confident this is the best treatment plan for you,” advises the American Cancer Society. “If the second opinion is different from the first, these are some things you can do next:
- Make an appointment with your first doctor to talk about the second opinion.
- Ask both doctors to explain how they arrived at their treatment plan.
- Ask them how they interpreted your test results.
- Ask what research studies or professional guidelines they consulted.
- Ask what they have recommended to other patients in your same situation.
- Ask if it is possible for the two doctors to review your case together.”
If after these steps you have more questions than answers, then seek a third or even a fourth opinion. As reported by AARP.com, R. Ruth Linden, president of Tree of Life Health Advocates in San Francisco notes that "patients often have better outcomes when they go into treatment with confidence rather than half-heartedly or with worry.”