When to get a second opinion

When to get a second opinion

Getting a second opinion for a medical condition isn’t quite the same as cheating on your hairstylist. In fact, when it comes to complex or serious, life-threatening conditions, most doctors encourage second opinions.

“If you don’t have complete trust in your physician, or you have reason to believe that all options have not been presented, you should consider a second opinion,” said Barbara Miller, M.D., chief of pediatric hematology/oncology at Penn State Children’s Hospital.

Sometimes, a doctor will even recommend that a patient seek out a second opinion if there are treatment options that he or she can’t offer.

“When you have a serious disease for which the therapies are controversial or changing very quickly, a second opinion may offer the possibility of new experimental drugs or therapeutic approaches,” she said.

John Messmer, M.D., a family medicine physician at Penn State Health Milton S. Hershey Medical Center, said the most important thing is for the patient to have a primary care provider whom they know and trust and who can make referrals and coordinate care and opinions from specialists.

When a situation is urgent and decisions must be made at once — maybe a patient comes to an emergency department with chest pains and is sent to have a clot dissolved — there is no time to seek out a second opinion.

And many straightforward conditions — such as a hernia that needs to be repaired or a gallbladder that must be removed — have standard treatment protocols with very little controversy about how best to proceed.

If you do decide to get a second opinion, both doctors suggest checking with your insurance company to make sure it will be covered. Many health insurance plans will cover a second — or even third — opinion, as long as you can justify the reason for it.

“I think many of them realize there is not always one clear answer,” Messmer said. “Now, if you get six opinions, they may start to question that.”

He adds it’s probably best not to go to one of your doctor’s partners for a second opinion.

“Sometimes people who tend to approach things the same way tend to practice together,” he said.

Messmer also recommends thinking through the decision to go to a different institution.

“Sometimes it makes sense if someone is doing something somewhere that is unique; or maybe they have a special program set up,” he said. “But if your condition requires recurrent visits or if you have complications, you have to go back there because the people at your home institution may not have all the details to manage things. So you have to make sure it’s worth it.”

Two starkly different opinions might not mean one is right and one is wrong.

“Different people may do things different ways, but it doesn’t necessarily mean that one is better,” Messmer said.

Miller said most good physicians are confident in their skills and want their patients to have confidence in them, so if a patient asks for a second opinion, they are usually understanding and helpful rather than upset.

“As a physician, I would like to hear what another doctor considers to be a different option and why,” she said. “I think all of us want the patient to feel they have received the best therapy available.”

Messmer said many conditions are not clear-cut with an obvious best option.

“Sometimes you have to rely on your intuition and who you like best and feel most comfortable with,” he said. “A lot of the outcome often depends on how much faith you have in your physician and your belief that you have someone good taking care of you.”

(A Wellness Update is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at www.awellnessupdate.com.)