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Putting Yourself First with a Second Opinion

By Gary Gillis
Beth Israel Deaconess Medical Center Commentator

As a teenager in the late 60s, I never marched on Washington, D.C., or participated in a sit-in protest but, as was not uncommon among my peers, I found the notion of questioning authority quite appealing. There were, however, two exceptions - the nuns at St. Bartholomew's and doctors. Questioning the former meant immediate if not eternal punishment. Questioning the latter meant ... well, it was simply inconceivable.

"To some degree it is a generational thing," says Dr. James Hurst, Chief of the  Roberta and Stephen R. Weiner Department of Surgery at  Beth Israel Deaconess Medical Center and visiting professor at Harvard Medical School. "Think back to your father and mother. If they went to a doctor with, say, severe pain in their leg and the doctor said, 'I can fix that but I'm going to have to cut your leg off and then re-attach it,' they might not have thought twice about agreeing. It went beyond faith and trust. Doctors were all-knowing."

We now know that is not the case, which is why Dr. Hurst spends a great deal of time advocating the position that there is nothing wrong with seeking a second opinion. Indeed, it's your right as a patient.

"No procedure is minor when it's performed on you. I say it to my patients and to my students all the time," he explains. "As a surgeon, I have performed hundreds of hernia and gallbladder operations, and while many are relatively straightforward procedures, they are never 'routine.' Routine is a diagnosis made in retrospect."

While Dr. Hurst understands that many patients have trouble asking for a second opinion, he wants you to understand this - it is NEVER INAPPROPRIATE to do so. In fact, if you feel you are being pressured not to, that's all the more reason to do it.

"Always be concerned when a surgeon discourages you from seeking another opinion. To me it says he or she is trying to hide something," he notes. "They may be uncomfortable with what they are telling you or perhaps not be well-versed in the procedure they are suggesting. It's not about hurting the surgeon's feelings or insulting them. Everybody has to be comfortable with the relationship; the patient, the doctor and the patient's family."

One way to develop that comfort is to do a little research on your own. There is a wealth of information available online. Dr. Hurst says many of his patients have gathered a good deal of information about their condition on sites like WebMD, but he also encourages them to learn about their doctors.

"You can go to the Mass Medical Board site and find out where your doctor went to medical school, where they trained, whether or not they are board certified, and what their area of expertise is," he advises. "I would also suggest you ask for recommendations from friends and colleagues, and certainly from your primary care physician. We have no problem researching washing machines in Consumer Reports or test-driving a car before we buy. You can't test drive a surgeon, but you can find a lot of information that will help you make a good decision."

Dr. Hurst's advice doesn't apply just to surgeons either. Whether it's a suggested medication or a diagnosis that you are uncomfortable with, seeking a second opinion is never a bad idea.

"I like to say that I flunked mind reading, and I broke my crystal ball. If you feel you are not getting the information you want, look for it elsewhere," he says. "Sometimes it's comforting and reassuring to think a doctor has all the answers, but that's simply not the case."

It may be an adjustment, but Dr. Hurst assures me that we should never be afraid, ashamed or hesitant to approach our doctors and tell them that we are seeking a second opinion. I now believe that. (But I'm not sure it applies to nuns.)

Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.

Posted October 2008

Contact Information

Department of Surgery
Beth Israel Deaconess Medical Center
West Campus, Lowry Medical Office Building
110 Francis St.
Boston, MA 02215