Dr. You

When facing a serious medical diagnosis or treatment decision, seeking a second opinion is wise. Obtaining a second opinion means consulting another doctor’s perspective on your condition and care plan. This section guides you through the steps to getting a second and third opinion.

Sometimes, doctors get it wrong. Here is an example excerpted from an article authored by Kristine Crane and published in U.S. News & World Report on July 23, 2014.

Patient Story – Trisha Torrey had a golf-ball-sized growth in her abdomen misdiagnosed as a rare and fatal tumor. Her surgeon removed the growth and wanted to start chemotherapy immediately. Trisha didn’t sleep for weeks as she researched her condition. Meanwhile, Trisha’s test results, including blood work and CT scans, showed no sign of any cancer. Trisha asked the doctor for a second opinion. However, her doctor said that her condition was so rare that no one would know more about it than he did. This is what finally set Trisha off to start advocating for herself.

She requested her medical records and discovered the missing test results. A friend helped her to find another doctor. The new doctor sent Trisha’s test results to the National Institutes of Health (NIH). Their diagnosis was that Trisha did not have cancer at all. She had an inflammation of her fat cells. While this mistake cost Trisha a great deal of her savings, it saved her the cost, pain, and emotional stress of undergoing unnecessary chemotherapy.     

The most common areas for second opinions are cancer, neurology, cardiology, and orthopedics. According to a 2015 Wall Street Journal article by Sumathi Reddy, a recent study of more than 6,700 second opinions found that the original diagnosis was changed in 14.8% of cases, and treatment changes were recommended in 37.3% of cases.  

Since doctors are generally viewed as trustworthy, caring, and honest, it is easy for any patient to feel that their doctor will be offended if they seek the opinion of another doctor. Do not let this feeling prevent you from getting a second opinion. Good doctors are comfortable with their patients seeking the opinion of another doctor and often encourage it

Why Get a Second or Third Opinion?

• Confirmation: A second opinion can confirm your initial diagnosis, providing you with confidence in your treatment plan.
• Different Perspectives: Doctors may have different treatment approaches. A second opinion can offer alternative options you may not have considered.
• Reduced Errors: Studies show that initial diagnoses are revised in a significant number of cases after a second opinion. One study found that original diagnoses were changed nearly 15% of the time, and treatment recommendations changed more than 37% of the time after a second opinion.
• Empowerment: Understanding your condition and options empowers you to make informed decisions about your health.

When Should You Seek a Second Opinion?

Consider a second opinion in these situations:

• You’ve been diagnosed with a serious illness (e.g., cancer, heart disease, neurological disorder).
• Your diagnosis is unclear or unconfirmed.
• You have multiple medical conditions.
• You have several treatment options.
• The recommended treatment is risky, controversial, or costly.
• You’re interested in treatment options your doctor isn’t familiar with.
• You’re considering a clinical trial or experimental treatment.
• You’re considering no treatment.
• You’re not responding well to your current treatment.
• You’ve lost confidence in your current medical team.
• You feel uncomfortable with the advice you’ve been given.
• Your insurance requires it.

How to Get a Second Opinion: Step-by-Step

Talk to Your Current Doctor

Be open about your desire for a second opinion. Most doctors are comfortable with this and may even offer recommendations. If your doctor discourages you or seems offended, consider finding a new doctor altogether. A good doctor will support your right to seek additional input. You could say something like: “I respect your opinion, but I’d like to get a second opinion to be absolutely sure I’m making the right decision. Would you be able to recommend someone?”

Gather Your Medical Records

Request copies of all relevant medical records from your doctor’s office, including:

• Test results (blood work, imaging scans, etc.)
• Biopsy reports
• Doctor’s notes

Ensure these records are sent to both you and the second doctor well in advance of your appointment.

Find a Specialist

Look for a doctor who specializes in your condition and has extensive experience treating it.

• Check with your insurance company for a list of in-network specialists.
• Consider doctors at major medical centers or teaching hospitals.
• Ask your primary care physician for referrals.
• Research doctors online.
• Check their credentials, board certifications, and any disciplinary actions.
• Read patient reviews (but take them with a grain of salt).
• Ask other healthcare professionals (nurses, pharmacists) for recommendations.

Check Your Insurance Coverage

Contact your insurance provider to understand your coverage for second opinions.

Ask:

Schedule the Appointment

• Is a second opinion covered for my condition?
• Do I need a referral from my primary care physician?
• What are my out-of-pocket costs (co-pays, deductibles, etc.)?
• Are there any restrictions on which specialists I can see?

When you call the second doctor’s office, explain that you’re seeking a second opinion.

Provide your insurance information, and ask about any specific requirements (referrals needed, paperwork, etc.). Ask if the doctor has time for a brief phone consultation to discuss your case.

Prepare for the Appointment

Write down a list of questions to ask the second doctor. Here are some examples:

• Do you agree with the original diagnosis? If not, what is your diagnosis?
• Are there any other tests you recommend?
• What are the treatment options, and what are their pros and cons?
• What are the potential risks and side effects of each treatment?
• How will treatment improve my health and quality of life?
• What is the recovery period?
• What happens if I delay or choose not to have treatment?
• Do you have experience treating my specific condition?
• What are your qualifications and expertise in this area?

Bring a friend or family member for support and to take notes and consider recording the appointment (with the doctor’s permission).

During the Appointment

• Be honest and open with the doctor.
• Clearly explain your medical history and concerns.
• Ask all your prepared questions.
• Take notes or have your companion take notes.
• Don’t be afraid to ask for clarification if you don’t understand something.
• After the Appointment:
• Ask the doctor for a written report of their findings and recommendations.
• Make sure the report is also sent to your primary care physician.

Review the second opinion carefully and compare it to the first opinion. Here’s what to do if opinions about the diagnosis or treatment are different:

• Diagnosis Agrees, Treatment Differs: Discuss the different treatment options with both doctors. Do additional research. Consider a third opinion focused specifically on treatment.
• Diagnosis Disagrees: Seeking a third opinion from a specialist is highly recommended. This can help clarify the correct diagnosis and guide treatment decisions.

Online Second Opinions

While convenient, online second opinions have limitations. Ideally, the doctor should perform a physical exam and conduct necessary tests. If considering an online service, ensure its reputable and involves qualified specialists. Be aware that insurance coverage may vary.

The Cost of Second Opinions

Most insurance plans cover at least part of the cost of a medically necessary second opinion. However, depending on the complexity of the case and the need for additional tests, out-of-pocket costs can range from $500 to $5,000 or more, depending on the complexity of the case and the need for additional tests. Always check with your insurance provider beforehand to understand your coverage and potential expenses.

Medicare, for example, covers 80% of the cost. If the second opinion does not agree with the first, Medicare will pay 80% of the cost of a third opinion. If you are in an HMO, your plan may require your primary care physician to approve your second opinion. If you are a Medicare recipient, you can get more information about second opinions by calling 1-800-633-4227.

Key Takeaways

• Inform your doctor(s) that you would like a second opinion.
• Getting a second opinion is your right and can significantly improve your medical care.
• Be proactive in gathering information, finding a qualified specialist, and understanding your insurance coverage.
• Don’t hesitate to ask questions and advocate for your health.
• You will need your records transferred to the new physician.

To take control of your health, consider getting a second opinion to ensure you have all the facts and are fully informed about your diagnosis, prognosis, and treatment options.

Disclaimer: This information is provided for general knowledge and informational purposes only and should not be considered medical advice. It is essential to consult with a qualified healthcare professional about any health concerns or before making any decisions related to your health or treatment.