Better Health & Living

Issue: August 2008
When You Need a Second Opinion
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When You Need a Second Opinion

by Susan Flagg Godbey

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Faced with a scary diagnosis, the possibility of surgery, or a medical problem that just won’t go away? A second opinion could change everything—or boost your confidence about your first doctor’s approach. Yet a recent Gallup Poll shows that half of the people who might benefit from a second look never get one.

Proof that second opinions are worthwhile: When 231 women with newly diagnosed breast cancer asked Northwestern University experts for second opinions, one in five got advice that was significantly different from the recommendations made by their primary doctors. And when Johns Hopkins University scientists reviewed 6,000 cancer second opinions, they found that doctors had made completely wrong diagnoses 1.4 percent of the time.

“A second opinion can relieve any doubts you have and be tremendously reassuring,” says Jonathan Schaffer, MD, an orthopedic surgeon at the Cleveland Clinic and managing director of MyConsult, the clinic’s online second second-opinion service. “It can also open doors to treatments that hadn’t been considered or even help you avoid problems. But people don’t always get second opinions. They’re often afraid their first doctor will be angry, or they don’t know where to go to get one.”

Here’s what you need to know in order to get a valuable second look. 

I have some chronic health conditions, not a life-threatening problem. Should I get a second opinion about the best medications and treatments, too?

A: It’s worth getting a second opinion whenever you feel additional information about your health is needed. You may feel you need one if your doctor suggests surgery or wants to prescribe a long-term drug or other treatment with serious side effects, or if you have a medical condition that’s simply not improving. You may want to know whether your diagnosis is correct, whether the treatments recommended are best for your condition, and whether there’s anything more you should be doing.

I’m worried that my doctor will feel insulted if I go for a second opinion. What should I tell her?

A: Most doctors will understand. Getting a second opinion doesn’t mean you distrust the doctors who are currently treating you. Given the pressures on those of us in health care right now—with office visits getting shorter, and the amount of information providers have to transmit increasing—everyone’s at a disadvantage. You can always use more information. If your doctor discourages you or becomes upset, that could be a red flag.

How can I find the right doctor to give me a second opinion?

A: If you’re looking for a fresh point of view about a fairly common medical problem, look for an experienced doctor affiliated with a different hospital or practice. Ask trusted friends, neighbors, and co-workers who which doctors they’ve seen and whom they would recommend for similar health conditions. One way to ensure that you see a doctor who’s extremely knowledgeable is to find out if they’re board- certified in the type of medicine that covers your concern. You can check with the American Board of Medical Specialties (www.abms.org).

If you have a serious, complex, or rare condition, a doctor affiliated with a major medical center or university hospital is a good choice. That’s also a good place to find more information about new treatments and procedures.

Be sure to have your current doctor send your test results and records before your second second-opinion visit so the new doctor has as much information as possible.

I’ve learned a lot about health problems my family has by looking up information online. Isn’t that enough?

A: You can get a lot of information that way and may learn about new treatments, but it’s very difficult to judge the quality of the information and whether it really applies to you. You can use the Internet to get a second opinion through several online services affiliated with major medical centers. These include MyConsult, affiliated with the Cleveland Clinic (www.eclevelandclinic.org), Johns Hopkins University’s Remote Medical Second Opinion service (www.jhintl.net/forpatients), and Partners Online Specialty Consultations, from the hospitals affiliated with Harvard Medical School (https://econsults.partners.org). For a fee ($600 to $800 at MyConsult), you get access to the institution’s top doctors, who review your medical records and provide a detailed report.

Once I have a second opinion, what’s the next step?

A: Have the new information sent to your primary doctor or take it to your next appointment. The new opinion may support what you and your doctor are already doing or suggest a different approach. Have a conversation about it and go from there.

By Susan Flagg Godbey and the editors of Better Health & Living®

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