How To Get a Second Opinion

Second Opinions and Surgery

Four Surgeons At Work
Four Surgeons At Work. Image: © MedioImages/Getty Images

Question:

My surgeon seemed upset and angry that I was seeking a second opinion. What should I do?

Answer:

Many patients are leery or embarrassed to ask for a second opinion when they are considering surgery. They worry that they might offend their surgeon, that they will get an second expensive and unnecessary bill for a surgical consultation, and they worry that a second opinion is a waste of time.

In reality, a surgeon who is upset or angry that a patient sought a second opinion isn't behaving professionally, as a second opinion is considered a normal part of the process.  You have no obligation to discuss your second opinion with anyone other than the physician providing it.

Truly, there is no reason to feel uncomfortable with seeking a second opinion -- obtaining as much information as possible prior to having surgery is the best way to make the right decision. If your surgeon is upset by your decision to obtain a second opinion, do not take it personally. It is highly unlikely that your surgeon would not obtain a second opinion if it was their health at stake! 

Would you buy a car or a house without talking to a few friends or family members about the decision? Most of us absolutely would discuss a major life decision with people we trust.  The decision to have surgery and who will perform that surgery, in many ways, is more important than a major purchase.

 We are talking about your health, your well being and, of course, about surgical skill and surgical opinions--which vary.

How important is a second opinion? Important enough that Medicare Part B will pay for second opinions for medically necessary surgeries, as do many insurance companies. Some will even pay for a third opinion if the first two surgeons have different opinions.

Keep in mind that insurance companies will not pay for a second opinion for surgeries that are not necessary, such as cosmetic procedures, but you know that when an insurance company is willing to pay for something it is considered a need not a want.

How To Get a Second Opinion

It is up to you whether or not you share your intention to seek a second opinion with a surgeon that you’ve had a consultation with. If you are embarrassed or uncomfortable discussing your desire to have a second opinion, you are not required to do so. Some patients feel as though they are betraying their surgeon by seeking another point of view, but a second opinion is common. 

If you choose to share your plan to seek a second opinion, your surgeon may be able to recommend a surgeon they are familiar with. Your surgeon may recommend a physician in their own office, or someone they are not affiliated with. Whether or not you use this recommendation is strictly up to you.

If you choose to find your second opinion yourself, you can use the same tips for finding a great surgeon that you would for your first opinion.

You will need to make sure that copies of any tests, x-rays, scans and hospital admissions related to your condition are sent to the physician who is giving the second opinion. You may or may not want to have your first physician share their opinion with the second physician as well.

When To Get a Second Opinion

A second opinion is advisable any time you are considering a surgical procedure. It is also advisable if you feel your goals and the goals of your surgeon are not the same. For example, if you are trying to avoid surgery and are seeking alternatives to the procedure, and your surgeon insists that surgery is the only option, you should seek a second opinion.

If you feel that your questions about the procedure are not being answered, or you don’t feel that your rapport with your surgeon is what it should be, consider seeking another surgeon. Also, if your "gut instinct" is making you uneasy about your choice of surgeon, don’t ignore the impulse -- seek out a second opinion.

When a Second Opinion Is Not Possible

There are some situations where waiting to obtain a second opinion could be dangerous or even life-threatening, or at least increase the risk of surgery. In the case of traumatic injuries, such as internal bleeding from a car accident, broken bones, or a suspected organ injury, waiting could be dangerous.  

In the event of an unexpected but acute illness, such as appendicitis or a potential blood clot, delaying surgery could result in death. Brain injuries, such as a brain hemorrhage, head trauma, or penetrating injuries, are among the problems where seconds count, so a second opinion would not be appropriate.

In general, surgeries referred to as “emergency procedures” will need to be performed without the benefit of a second opinion. That doesn't mean that you should not have one, large facilities often have multiple surgeons who practice the same specialty, and if a second opinion happens to be available you can certainly choose to have one. 

Sources:

Getting a Good Second Opinion. Yale-New Haven Hospital. Accessed May 2010. http://www.ynhh.com/choice/secondopinion.html

Getting a Second Opinion Before Surgery. Centers for Medicare and Medicaid Services. Accessed May 2010. http://www.medicare.gov/Publications/Pubs/pdf/02173.pdf

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