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Second Opinions

Posted 8/16/2016

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  Sometimes it is important and helpful to have a second medical opinion. Sometimes doing so just costs more money and complicates/confuses things. How do you know when it is a wise idea?

  There are predictable moments when the idea comes up: at diagnosis, if there is an important treatment decision to be made (e.g. mastectomy or wide excision/radiation), if cancer is progressing and various treatment options have been presented. Remember that many situations have a clear standard of care, and all good doctors will recommend the same thing. In those cases, you might want a second opinion because you are considering two different hospitals and want to check out the cultures/how they feel or because you aren't sure about the fit with your doctor and want to speak with another surgeon or oncologist to assess the relationship.

  Most insurances will cover a second opinion, but it is smart to check this out before making an appointment. Insurance may not cover duplicate expensive tests, so ask about that, too. Your second opinion doctor's office will ask that you bring your records, copies of any scans, pathology reports, etc. Sometimes you are responsible for going to Medical Records and gathering this information, and sometimes doctor's office #1 will take care of the chore.

  Before making a second opinion appointment, think carefully about what you are hoping to accomplish. Do you want to feel more comfortable with your doctor? Are you hoping to avoid a surgery or a treatment that sounds especially difficult? Is there a choice between chemo #1 and chemo #2 and you don't know how to decide? Are you thinking about clinical trials and wonder if others are available and potentially useful? Remember that a second opinion may well be helpful in clarifying your thinking, but it is possible that it will make things muddier. What if Doctor #2 suggests something totally different? (not so likely, but possible) Do you then need a third opinion as a tie breaker?

  My own bottom line is this: If, after thinking about all of this, you are still wondering if you should have another opinion, the answer is absolutely yes. What you don't want is to look back and this moment and wish that you had done so.

  For more on this:

Before You Get a Second Opinion . . .
By Wendy Baer, MD

“They say you should always get a second opinion – do you think that’s true, doc?”
The question came from Lewis, a 55-year-old truck driver who had been diagnosed with kidney cancer the
month before. Friends had urged Lewis to get a second opinion, “just because you always should,” so he
arranged to get a second opinion from an oncologist in another city. But as the trip got closer, he began to
wonder if getting a second opinion was the right thing to do.
Getting a second opinion seems logical: When you are faced with a cancer diagnosis you want to make
sure you are getting the best treatment possible – and finding the best treatment means looking around,
right? But might there be a down side for Lewis going to see another oncologist to get a second opinion
about how to treat his kidney cancer?
Probably the most challenging part of getting a second opinion is dealing with any new information,
potentially different than what you were originally told, about how to treat your cancer. The second
opinion plan may involve a different medication, new kind of surgery, or an alternate radiation schedule.
Once you have that information, you then have to decide which treatment plan to follow.


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