Your doctor walks into the room with your test results. She looks concerned. The symptoms you’ve been worried about indicate a serious problem and she wants you to start a regimen immediately. You can’t think, your heart is racing and your first instinct is just to follow orders.
On the contrary, consider this: your doctor bounces into the room smiling. The test results are normal. No need to worry about those symptoms that have you so concerned. She writes you a prescription and schedules you for a follow-up in six months. Whew! Yet…why do you feel uneasy?
Both scenarios require the same action: a second opinion. A second opinion is when another doctor (in addition to your regular doctor) gives their view about your health problem and how it should be treated.
“Wouldn’t you rather start treatment knowing you have explored all options and have two (or three) doctors concurring?”Dr. Tammy Porter
Before you start to worry about asking for a second opinion, consider the following: a 2015 study showed a second opinion resulted in treatment changes for nearly 37% of patients and diagnosis changes for 15%.2 That’s a 1-in-3 chance that your doctor’s recommendation may not be your best option!
You deserve to know all options before choosing the best care plan for a serious condition. Besides, your doctor consults their colleagues every day – it’s a common practice in medicine. Their Code of Medical Ethics3 includes assuring patients they may seek a second opinion and not terminating you just because you seek care from another professional. A second opinion may just confirm your doctor’s recommendation and it’s not a waste of time. Wouldn’t you rather start treatment knowing you have explored all options and have two (or three) doctors concurring? A second doctor may just be able to explain the plan in a better way for you to understand, and you are free to return to your original doctor for treatment. If your doctor becomes angry or offended, that is not someone you want on your medical team. Remember – it’s your health, not your doctor’s. Here are answers to some common questions:
How do I get a second opinion?
First, you do not need your doctor’s permission. However, asking them to refer you (outside of their group/organization) makes it easier to transfer records to your new doctor. To start the conversation, consider this: “Before we start treatment, I’d like to get a second opinion. Will you help me with that?” Or, “I think I’d like to talk with another doctor to be sure I have all my bases covered.” Don’t worry about your doctor influencing the second opinion, receiving doctors know it is their job to reevaluate all the information and often order some additional testing. A good doctor will help you find an expert and get you an appointment ASAP.
Will insurance cover this?
Most insurance plans, including Medicare, cover second opinions. Contact your insurance provider first so you follow their protocol as some require prior authorization and/or use of a provider in their network. Medicare (with Part B and Original Medicare) will not only pay for a second opinion but also a third if the first and second differ.1 If the planned tests/treatments are medically necessary, Medicare pays 80% and you pay 20% after your deductible. Medicare Advantage plans assure you the right to a second or third opinion but may require a referral from your doctor. Contact your plan for more information.
Meeting with the second doctor
A specialist does not know you as well as your doctor. Be clear and specific about your intentions and avoid generally stating “I want to see what you have to offer.” Before your appointment, call ahead and make sure they have received all your records. Prepare in advance with a list of questions, and take all your medications and any recent summary sheets from doctor visits or hospital stays with you. Do not go alone! Take your health advocate, family or friend to listen and take notes. Consider these questions:
- Could there be a different explanation for my symptoms?
- What are your recommendations?
- Are there other treatments I should consider?
- Any additional testing I need?
- What are the risks/side effects of my treatment options?
- What if I do not choose to move forward with this plan?
- What are the costs?
- What does recovery look like?
- What research studies or professional guidelines are they following?
- Is this what you would recommend for your family member?
- What is the outcome expected for each option?
After you have met with your second (or third) doctor, make an appointment to see your original doctor and see if all the doctors reviewed or will review the recommendations together. Going into treatment confidently, knowing you have considered all options, can assure a better outcome, even if the original treatment plan stays the same.
Important: do not wait for a second opinion if you require emergency surgery for conditions such as appendicitis, blood clots/aneurysms and accidental injuries.
Dr. Porter is CEO and founder of MyHealth.MyAdvocate in Palm Desert. She is an experienced health care professional with 30 years of nursing practice dedicated to unraveling the mysteries of health care processes and advocating for patients, families and caregivers. Immediate assistance is available by calling (760) 851.4116. www.myhealthmyadvocate.com.
Sources: 1) Medicare-Getting a Second Opinion Before Surgery. https://www.medicare.gov/Pubs/pdf/02173-Getting-a-Second-Opinion-Before-Surgery.pdf; 2) Evaluation of Outcomes From a National Patient-Initiated Second-opinion Program https://www.amjmed.com/article/S0002-9343(15)00369-1/fulltext; 3) AMA Code of Medical Ethics Opinion https://www.ama-assn.org/delivering-care/ethics/consultation-referral-second-opinions.