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When to get a second opinion

Created date

May 21st, 2013
Three doctors

Most people know about the importance of getting a second opinion about their treatment options when they receive a serious or potentially life-threatening diagnosis, such as advanced heart disease or cancer. But according to experts, there are other instances in which getting a second opinion is a good idea.

When a second opinion is prudent

“Studies show that many orthopedic surgeries are done too often,” says Jeffrey Spike, PhD, a medical ethics expert and professor at the McGovern Center for Humanities and Ethics at the University of Texas Health Science Center at Houston. “It depends on someone’s age and health status, but some people would benefit just as much with physical therapy, medications, or minor procedures such as cortisone injections. Many medical experts agree that people who are considering spinal fusion, knee arthroscopy, or even a hip fracture repair should get a second opinion.”

Another common heart procedure warrants another doctor’s viewpoint. “Stent placements for people with stable angina are performed too frequently in the U.S. It’s one of the factors responsible for our country’s high health care costs,” Spike says.

Even a usually minor problem can be up for debate. “Having cataracts doesn’t always mean you need surgery,” Spike says. “Some are minor and may never affect your vision. Why reconsider what is seemingly a common and straightforward procedure? Because cataract surgery (like any other surgery) is not without risks. Possible complications include infection, bleeding, and retinal detachment.

Surgery, whether major or minor, is not the only instance in which a second opinion may be called for. For many chronic health conditions, you may want to consult with a specialist who has a lot of experience with that particular disease, especially if you think you’re not as healthy as you could be. An endocrinologist, for example, knows all of the ins and outs about diabetes and may be able to help you if your disease is not under control. Geriatricians are also a good resource because of their extensive knowledge of the unique problems faced by seniors with several health problems. Consult and discuss your intentions with your primary provider before seeing a specialist.

Other considerations

Conservative treatment is not always the best option. “Older adults with severe knee arthritis who have significant pain and disability should get a second opinion if an orthopedic surgeon tells them that arthroscopic surgery—usually to repair torn cartilage—will alleviate their symptoms,” says Geoffrey Westrich, M.D., an orthopedic surgeon and director of research of the Adult Reconstruction and Joint Replacement Service at the Hospital for Special Surgery in New York, NY. “Many people with advanced knee arthritis are candidates for knee replacement surgery, and this is their best option to relieve pain and restore mobility.”

A practice that is similar to getting a second opinion is asking a lot of questions when you are in the hospital. In 2011, a study published in the journal Health Affairs found that hospital errors may be much more common than previously thought. As many as one in three people admitted to the hospital have an adverse event or medical error occur. To protect yourself, ask nurses to double-check medications before they are given to you. If you don’t understand something that’s being explained to you, say so. Have a trusted family member or friend by your side to ask questions for you if necessary.

How to get a second opinion

“Your primary doctor can be a great resource for a second opinion,” Spike says. They tend to have good contacts in the community. You can also ask for recommendations from family and friends.

With surgery, experience is best. “You want to find a doctor who has performed a particular surgery for many years,” Spike says. “The more often they’ve done a surgery, the more skilled they are. Don’t be afraid to ask a doctor how many times he’s performed a particular procedure.”

Important things to remember

• Check your insurance coverage. Insurance providers may only pay for a second opinion in certain instances, and they may only approve certain doctors.

• Arrange to have medical records sent to the second doctor before your appointment.

• Do your own research before the appointment. Stick with reliable sources such as government websites, professional associations, or health information from academic medical centers.

• Do not get a second opinion by phone. You need to be seen and examined by a doctor.