• When and How to Get a Second Opinion

    IMAGE Jack, a 50-year-old office worker, discovered a small lump on the side of his neck. He scheduled a visit with his primary care doctor, who examined the lump and ordered tests. When the tests results were in, Jack's doctor explained that the lump was "pre-cancerous." Treatment options were to closely monitor the lump or have it surgically removed.
    Explaining the pros and cons of each option, the doctor stated that, in his opinion, the best option would be to remove the lump. After asking his doctor a number of questions, Jack said he would like to take a few days to think about what to do. The doctor agreed and suggested that Jack consider getting a second opinion. In Jack's case, the second opinion confirmed the impression of his primary care doctor.

    When Should You Get a Second Opinion?

    What if your doctor does not suggest that you seek out a second opinion? How do you determine whether your situation warrants one?
    Unless your condition is life threatening and requires immediate emergency care, it is virtually never a bad idea to seek a second opinion. In many cases, seeking a second opinion is not only warranted, but necessary. These circumstances include anytime the following occurs:
    • A condition or problem is considered serious.
    • Surgery is one of the treatment options suggested.
    • Numerous possible treatment options are available.
    • After consulting with your doctor, you still have a number of unanswered questions.
    • You are told by the doctor that a specific type of treatment cannot be used to treat your condition.
    • You are told by the doctor that nothing or nothing more can be done to treat your condition.
    • Your condition returns after treatment.
    • A cause for your symptoms is not found, but the symptoms continue.
    • You feel that there is something "wrong" with the diagnosis or suggested treatment for your condition.

    Is It Too Late?

    What if you begin receiving treatment, and then decide that you would like to get a second opinion? Is it too late? Although it is best to seek a second opinion soon after a condition or problem is diagnosed, it is never too late, even after a course of treatment (with the exception of surgery) has begun.

    Why Should You Bother With a Second Opinion?

    There are a number of benefits to getting a second opinion, including:
    • Having a better understanding of your condition
    • Getting your questions answered
    • Removing any doubts
    • Helping you to weigh the benefits and risks of the recommended treatment options
    • Helping you to make an informed, educated decision as to what treatment is best for you
    Because medicine is not an exact science and many conditions can mimic the symptoms of other conditions, diagnosis can be difficult. As a result, getting a second opinion can be integral to making certain that the original diagnosis is correct.

    How Do You Get a Referral?

    You can ask your doctor for a referral. In most cases, a reputable doctor will welcome this request. But like many patients, you may feel uncomfortable or uncertain about asking your doctor for this type of referral. But, it is actually common for patients to get second opinions, so your doctor will not be surprised or insulted if you bring up this subject. The bottom line is that—if the circumstances warrant a second opinion—be sure you get one.

    How Do You Find a Doctor on Your Own?

    If you need to find a doctor on your own, you can try:
    • Talking to another trusted doctor who may be able to recommend a specialist
    • Calling local hospitals, medical centers, or medical schools and asking for a referral to a specialist who works at or in connection with that facility
    • Calling your health insurance company for a list of specialists that are covered by your plan
    In addition, before making an appointment, check the doctor's background and training. Websites like the American Medical Association and the American Board of Medical Specialties provide searchable databases of doctors who have met certain standards.

    Will You Have to Pay for a Second Opinion?

    The cost of a second opinion depends on your health insurance plan and the doctor that you want to see.
    Before scheduling an appointment for a second opinion, check with your insurer to see if they cover second opinions, and if so, what restrictions are in place. Some health plans require a second opinion and will pay for it in full. Others will pay for it if you seek a second opinion from a specialist within their health care or insurance network. If you are in a position where you have to pay out-of-pocket for a second opinion, the cost will vary greatly depending on which specialist you see and whether tests need to be done.

    Will More Tests Be Done?

    This depends on your condition. In some cases, the doctor will want to conduct her own exam and may order additional tests. Or, the doctor will be able to use the results that have already been collected to evaluate your condition, verify or disagree with the original diagnosis, and suggest a treatment plan for you.
    To minimize wasting time and resources, make arrangements to hand deliver test results and a copy of your medical record to the doctor prior to your appointment.

    Who Do You Get Treatment From?

    This depends on you and the type of health insurance you have. If you would like to, you may be able to get treatment from the doctor that gave you a second opinion.


    Agency for Health Care Policy and Research http://www.ahrq.gov/

    American Medical Association http://www.ama-assn.org/


    Canadian Medical Association http://www.cma.ca/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/


    Groopman J. Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine. New York, NY: Viking Penguin Group; 2000.

    How to get a second opinion. Women's Health.gov website. Available at: http://www.womenshealth.gov/publications/our-publications/second-opinion-how-to.pdf. Updated September 10, 2008. Accessed September 23, 2011.

    Mestel R. Need a second opinion?. Los Angeles Times. February 15, 1999.

    Second opinions. Johns Hopkins Pathology website. Available at: http://pathology.jhu.edu/department/services/secondopinion.cfm. Accessed September 23, 2011.

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