What is a Real Second Opinion?
You are sitting on an examination table, wearing not much more than a Kleenex, and your physician is telling you that he/ she recommends surgery. You hear that word and everything else sounds like the teacher on Charlie Brown. “Wah, wah, wah, wah”. You’ve only seen this doctor once before and all of a sudden, your life is in their hands. What do you do?
The first thing you do is realize that doctors are all trained differently, may not be aware of other options available, or may not be as comfortable with some treatments as other physicians, and even if you know nothing about medicine, you are your own best advocate. Then you get a copy of your notes, including diagnosis codes and proposed surgical codes and start your homework. This means more than consulting “Dr. Google”. This means calling every medical person you know and getting names. It means calling your insurance company and finding out if second opinions are reimbursed. If they aren’t, it means getting the money together, because this is too important to pinch pennies on.
Some people make an appointment for a second opinion in the same office as the first, or get another name from the original doctor. I feel this is not a true second opinion. If these doctors share an office, or play golf together every Wednesday, they are unlikely to contradict each other. This is where having a friend or acquaintance in the medical community will come in handy. If you don’t have that, look into patient advocacy programs.
One point to consider is if you tell the second opinion that they are, in fact, a second opinion. Many people feel they should go in cold and have the appointment take place as if it were the original one. Another way is to book a second opinion but not to tell the second physician what the first one said. The last way is to tell the second surgeon what the first one said, and ask if they agree with both the diagnosis and treatment recommended.
If the second opinion is not the same as the first, they are not automatically right, just different. More research is called for, until you are convinced you are doing the best thing possible for present circumstances.
All this is moot if you are in an emergency situation, such as pending paralysis or death, but should be considered any other time a major medical recommendation is received. No one is perfect, but you are your own protection against getting an incorrect or incomplete diagnosis, or treatment. Any physician that argues this is suspect, and makes a stronger case for caution.
- Abbasi J. Shantanu Nundy, MD: The Human Diagnosis Project. JAMA. 2018 Jan 23;319(4):329-331. PubMed PMID: 29362789