You have a lump or a bump or an abnormality on your chest x-ray or CT scan. A more comprehensive workup reveals an ominous diagnosis, perhaps cancer, or the need for major surgery. What do you do? Before you embark on a life-long treatment or consent to a surgical procedure, you might consider getting a second opinion.
A second opinion is a visit to a physician other than the one a patient has previously been seeing in order to get a differing point-of-view. Second opinions may be sought by a patient under the following circumstances:
▪ You physician recommends surgery.
▪ Your physician diagnoses patient with serious illness (such as cancer) that patient does not believe they have.
▪ Your physician recommends a treatment other than what you believe is necessary.
▪ When your docotr recommends elective surgery, it may be required by the insurance plan. In other cases, insurance will not pay for a second opinion.
▪ If you believe that you have a condition that physician fails to diagnose. In some cases, the physician may be the one to recommend the second opinion.
▪ Your physician may even recommend a second opinion.
Don’t worry about hurting your doctor’s feelings. Most doctors welcome a second opinion, especially when surgery or long-term treatment is involved. Ask someone you trust for a recommendation. If you don’t feel comfort- able asking your doctor for a referral, then call another doctor you trust. You can also call university teaching hospitals, such as LSU and Tulane Medical School, and medical societies, such as the Louisiana State Medical Society, for the names of doctors.
Today many insurance companies require a second opinion before approving major surgery or expensive treatments such as chemotherapy or bone marrow transplants. You shouldn’t hesitate to tell a doctor that you want a second opinion, and you are entitled to your reports, your x-rays, and even your pathology slides that you might want to have reviewed by another pathologist. Now many major medical centers, including Johns Hopkins in Baltimore and MD Anderson in Houston, Texas have second-opinion services that doctors can refer patients to, or patients can contact directly in order to obtain an independent assessment.
What do you do if the second opinion differs markedly from the first diagnosis you received? In that situation a third opinion may be necessary to get a consensus on what course of treatment is best.
The wrong diagnosis can occur for various reasons. Pathologists and radiologists may misread slides and scans or fail to use the latest tests or technology. Sometimes doctors may simply get stuck on the idea of one diagnosis and ignore or overlook evidence it might be something else. It is estimated that radiologist will make a misdiagnosis about 8% of the time. For example a brain tumor might mistakenly be thought to be an infection, a stroke, or multiple sclerosis. The last thing you want to happen is to have a part of your brain, a kidney, breast or other organ removed and find out that this isn’t what was initially diagnosed.
What do you need when requesting a second opinion?
When given a diagnosis that is frightening or likely to require surgery, you want to ask for a meeting with your doctor and tell him\her that you would like a second opinion. Nearly every doctor will accept your request and help you prepare your records that you will need to take with you. You want to take a complete copy of your records with you to your second opinion doctor. Also take your original x-rays, the reports, and also any pathology slides with you. You will want to make an appointment with another physician and explain that you are coming for a second opinion. If the second-opinion doctor agrees to see you, send all of your records to the doctor and be sure that he\she has had an opportunity to review your records before your appointment. I also suggest that you bring another copy of your records with you in case the records you sent are misplaced or lost in the office.
You will want to ask the second opinion doctor if he\she reviewed the materials related to your case. You will want to know if the tests, x-rays, and biopsies were adequate to make a firm diagnosis. Find out if the doctor thinks that one of the tests needs to be repeated or if additional tests are required. Ask the doctor to confirm the diagnosis or find out what other diagnoses may be considered.
Online Second Opinions
Some patients will seek a second opinion online. This is a service offered by some clinics. Doing so enables patients to take advantage of the wealth of medical information found on the Internet, and to avoid traveling to visit the clinic in person. But the face-to-face visit with the physician is lost, and not all medical insurance plans will cover the cost. When you get a second opinion, you need to be seen by a doctor. That doctor will perform a physical examination and perhaps other tests. The doctor will also thoroughly review your medical records, ask you questions, and address your concerns. This cannot be accomplished over the Internet. The American Medical Association doesn’t oppose online second opinions, but it does say in-person visits offer more benefits.
Getting a second opinion from a different doctor might give you a fresh perspective and new information. It could provide you with new options for treating your condition. Then you can make more informed choices.
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