The Art of Obtaining a Second Opinion
I am often asked by patients who are confronted with an elective procedure if they could obtain a second opinion. Many patients are uncomfortable asking a doctor for a copy of their records and telling the doctor that they are seeking out another opinion.
The American Medical Association states it is a patient’s prerogative to seek a second opinion. A recent report by the AMA, published in April of this year, found in an examination of nearly 300 patients, only 12% of first diagnoses were the same as second diagnoses. In 66% of cases, second diagnoses agreed with first opinions but were better defined and offered more information and options. In 21% of cases, final diagnoses were different than the original recommendation. Since one out of every five patients may be completely and incorrectly diagnosed; therefore, second opinions are necessary and prudent.
I believe it is a patient’s prerogative to seek other points of view, when the first doctor you visit recommends surgery or an invasive procedure for purposes of making a diagnosis. Sometimes, too, a second opinion can provide a patient with an alternative to surgery, which can be valuable. Also, avoiding a hospital admission can be positive because of the rates of hospital acquired infections.
Seeking a second opinion isn’t a common decision for most patients. A Gallup survey in 2014 said most patients have confidence in their doctor and haven’t or wouldn’t seek a second opinion.
I think patients planning to obtain a second opinion today is approximately 10 to 20%.
I actively encourage patients to seek other opinions when circumstances are serious, such as when:
- Patients receive a first-time diagnosis of a life-threatening situation or disease such as prostate cancer.
- They have serious and incapacitating symptoms and the doctor is unable to find the cause.
- When major elective surgery or treatment procedure is recommended.
My suggestion is that even if you are planning to proceed with the recommendations of the doctor, you should obtain another medical opinion.
I usually state, “I’m quite certain that this is the diagnosis or this is what you need to have done, but I’d even like you to see somebody else and also see if they agree.”
It is true that most patients genuinely trust their doctors. However, a review of the history, physical exam and the results of testing by another doctor will help the patient with the final decision and make the decision making easier.
Typically, medical insurance covers second opinions, particularly in cases with serious issues. Some even require them in the case of a costly procedure.
Now, second opinions can be sought not only through traditional channels but also via online sources described at the end of this article. Now, it is possible to obtain a second opinion, when a patient is at a great distance from the second doctor, using telemedicine.
Often patients are concerned about offending their doctor by asking for a second opinion. A doctor should not feel slighted or offended by a patient wanting a second opinion. The doctor’s ego shouldn’t get in the way. It’s about doing what’s best for the patient and what’s right for the patient.
In the event that there are different opinions between doctors, a third opinion would be sought to more likely ensure the correct diagnosis. In that situation, I often recommend that a patient go to one of the medical schools, where they can seek out the advice of an academic physician who might know the latest and greatest treatments and options.
Bottom Line: If your doctor recommends surgery or a treatment that has risks and complications, you are well advised to seek a second opinion. You will not offend your doctor.
Cleveland Clinic: my.clevelandclinic.org/online-services/myconsult
Massachusetts General Hospital: www.massgeneral.org/second-opinions
UC San Francisco Medical Center: www.ucsfhealth.org/secondopinion
Second Opinion Expert: www.secondopinionexpert.com/us
Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or www.neilbaum.com