Don t be afraid to request a second opinion

4/25/2005

Patients hesitate to get a second opinion because they fear it may insult their primary doctor and undermine an important relationship that s taken years to build.

Those fears often are nonsense.

Many doctors don t mind, or are relieved to have a helping hand on a difficult case involving a patient whose welfare is important. Doctors don t take it as a sign that patients lack faith in their ability or don t trust their judgment.

When should you consider a second opinion?

Medical centers like the Mayo Clinic, the Cleveland Clinic, and Johns Hopkins University provide thousands of second opinions every year.

Their guidelines on when a patient should consider a second

opinion:

• To confirm the diagnosis of a serious or life-threatening

disease.

• To review the doctor s treatment plan, especially if it

is traumatic, expensive, risky, or experimental.

• When a treatment doesn t seem to be working.

• When other uncertainties about the diagnosis or treatment

arise.

Keep those expectations realistic before moving ahead and running up a bill that may not be covered by health insurance.

Second opinions sometimes do lead to different diagnoses or new treatments. Patients may even decide to change doctors or hospitals to get different care.

Often, however, the second opinion is the same or similar to the first. There s no change in the diagnosis or treatment. Even then, the reassurance and peace of mind may be worth the effort and expense. Where do patients go for a second opinion?

Some are comfortable staying at home, and even asking their primary physician to suggest a nearby specialist perhaps

at a medical school or university medical center to provide the second opinion.

Others want a completely independent opinion from out-of-town. That does not always mean traveling to Johns Hopkins, for instance, or the Mayo Clinic for an examination.

The doctor may give a second opinion just by reviewing your medical records, X-rays, pathology reports, and lab test results.

The Internet has made it easier to get a second opinion.

Major medical centers have Web sites with information on second opinions. Just search for the center s name.

Some provide e-second opinions, in which the arrangements can be made remotely over the Internet.

The Cleveland Clinic may have taken this approach further

than other medical centers. Its Web site (www.clevelandclinic.

org/services/eclinic.htm) even posts the starting price $565 payable in advance with a credit card. The results go directly to the patient.

If you re considering a second opinion, talk it over with the doctor.

Check out local options, and use the Internet to compare second opinion services available at several different major medical centers. Check your insurance coverage.

Raising the topic can be as easy as saying that you ve been reading about second opinions in the newspaper or on the Internet, and would like to give it a try.