In medical language, a second opinion is the opinion of a different physician to the one who is primarily managing your condition. This can be very valuable in non-emergency situations and may even be required by your insurance company before treatment will be covered. But it can be difficult to determine when a second opinion is necessary.
In some instances, a second opinion can be markedly different from a first opinion. However, a second opinion often offers peace of mind to a patent who is faced with making choices about medical conditions and treatment.
If you feel you would benefit from a second opinion, choose your second physician carefully. Avoid seeking a second opinion from someone who is non–licensed or trying to make a profit by selling their product. Your original physician, insurance company or local hospital may be able to recommend a suitable physician for a second opinion.
About second opinions
In medicine, a second opinion is a diagnosis and/or treatment plan offered by a second doctor, after your doctor has already made a diagnosis and/or recommended a treatment plan for the same problem. The second doctor may be in the same specialty as your doctor (e.g., both cardiologists), or the second doctor may be in a different specialty (e.g., a licensed dietitian rather than a cardiologist).
People in an emergency situation have no time to safely seek a second opinion. However, getting a second opinion is important when:
You are feeling serious doubt about a major diagnosis, a potentially risky treatment plan or the competence of your doctor.
You are curious about other, less-invasive treatment options that your doctor either does not offer or does not support.
You are faced with several treatment choices and wish to gain more information to help with the decision.
You have thoroughly discussed the situation with your doctor and still have unanswered questions.
Your insurance company requires a second opinion before it will approve treatment.
Just like your original doctor, the second doctor will need to give you a physical exam. The second doctor will also need to review your records and the results of any tests that have been performed. You can obtain copies of your records and recent tests directly from your doctor, or you can ask your doctor to send copies of this information to the second doctor. In some cases, you may be asked to pay for copies of your medical records. You may also need to pick up some items, such as x-ray films, from the source to take with you on your appointment.
A second opinion is different from both a consult and a referral:
When your doctor chooses to talk to another doctor about your case, it is called a consult.
When your doctor sends you to another doctor for further evaluation or treatment, it is called a referral.
When you choose to talk to another doctor about your own case, it is called a second opinion. Your own physician may also request a second opinion.
Importance of board certification
If you’re going to get a second opinion, it is important to get one from a board-certified specialist. Whether or not the first doctor was a specialist, the second opinion will be more valuable if it comes from a board-certified specialist in the problem at hand.
For example, if you have an abnormal heart rhythm, see a board-certified electrophysiologist. If your child’s heart health is in question, see a board-certified pediatric cardiologist. If emotional factors (e.g., stress or depression) seem to be causing or worsening your symptoms, see a licensed psychologist or board-certified psychiatrist. If surgery has been recommended, talk to a board-certified cardiovascular surgeon – perhaps one who specializes in minimally invasive forms of surgery (e.g., minimally invasive bypass surgery or minimally invasive heart valve surgery). You might also talk to board-certified cardiologists, who do not perform surgery, to see if less invasive treatments are available for your condition.
If possible, choose a board-certified specialist who does not know or is not affiliated with your doctor, rather than another doctor’s in the same practice or one who is friends with your original doctor. Otherwise, the second physician may be put in an uncomfortable position that might not be in your best interest. In some cases, it may be best to seek a physician who is affiliated with a different hospital or medical facility than your primary physician. You may want to seek a second opinion from a specialist who has no vested interest in the recommendation, such as from a surgeon who is not going to perform the procedure.
Always be careful about seeking second opinions from anyone who is not board-certified, or who is recommending a product or procedure that is not approved by the Food and Drug Administration (FDA). For example, a vitamin salesperson may be eager to recommend his or her product instead of open-heart surgery. Or a “holistic” practitioner may encourage you to stop taking all your medication before following his or her “miracle” program. Some alternative/complementary practices can be beneficial for certain people when used in conjunction with traditional medicine. It is best if it is conducted under the supervision of a board–certified physician working in conjunction with an alternative–health practitioner. However, patients should be wary of radical advice that directly contradicts decades of modern medical research.
Finding a board-certified specialist
There are a number of strategies that can be used to find a board-certified specialist who is qualified to offer a valuable second opinion about your health:
Ask your doctor. A healthcare professional who is confident in his or her abilities should recognize that a patient’s fears need to be addressed rather than taking the request personally. Ideally, your doctor will do everything he or she can to assist you in finding a second professional and supplying that second professional with all necessary medical records and test results. However, try to avoid getting a second opinion from a doctor in the same practice as your original doctor.
Contact your insurance company. Does your health plan require a second opinion before treatment can proceed? If not, will the plan cover the expense of getting a second opinion? Which specialists would qualify for that covered service? Medicare, for example, will cover the expense of a second opinion from a Medicare provider if the patient has been diagnosed with a condition normally covered by Medicare (and if any necessary deductible has been met). To get a list of Medicare providers, contact your regional Social Security office or call 1-800-MEDICARE. Most insurance companies should be able to provide you with a list of specialists in your area who are covered under your plan.
Contact a local hospital, which may have a physician’s referral service. Often medical facilities will provide information about physicians who have privileges at their facility through community resources or on their website.
Talk to friends and/or family members about specialists they have seen. Who was trustworthy and knowledgeable? What has their experience been with these specialists?
Attend educational programs or support groups. Educational programs are frequently offered through hospitals or medical facilities on varied medical topics. You may find reliable, knowledgeable individuals at these programs who can refer you to qualified specialists.
When doctors disagree
What do you do when the second doctor has a very different opinion from the first doctor?
Ask questions of both doctors. What evidence does each doctor have to support his or her opinion? For example, what research is one doctor using to support a recommendation of cardiac catheterization? What research is the other doctor using to support a recommendation of EBCT or another test instead? Why does one doctor think that you are a good candidate for a minimally invasive procedure when the other doctor does not? Be sure to take notes on your sessions with all of your physicians. It is often hard to remember vital information when you are visiting several specialists. Also, written information is easier to refer to when discussing options with your physicians.
If neither doctor’s answers clarify the situation, you might start your own research on the subject. It is often a good idea to read the latest information about heart-related conditions, tests and treatments. This makes it easier to make informed choices about your condition. If necessary, consider getting a third opinion.
Questions for your doctor
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctors the following questions related to getting a second opinion:
What information did you use to make your diagnosis?
What type of specialists might provide additional information?
Who would you recommend for a second opinion?
What research or evidence are you using to support your treatment recommendation?
Are there any other alternate types of treatment available to me?
How much experience do you have with my medical condition?
What are your medical qualifications?
How much time do I have to seek a second opinion?
Where can I go to learn more about my condition?
How can I obtain copies of my medical records from your office?
