The Art of Getting a Second Medical Opinion

And sometimes you should seek additional medical consultations if you aren't being diagnosed at all, Linden adds: “If a physician is dismissive and not curious about understanding what's going on for a patient, and not willing to do a full workup and dig deeper, that's when it's time to seek a second opinion.” If you feel like your symptoms are being trivialized, or your doctor couldn't find anything but something is clearly going on, consult another physician.

Am I putting my relationship with my current doctor at risk?

Rest assured that getting second opinions is a simple, routine part of medicine. In fact, your physician may also be seeking one or more additional opinions. “Doctors ask their colleagues for curbside consults all the time,” Varma explains. “Sometimes a fresh pair of eyes and a new perspective help if you've had a long-standing relationship with a patient."

It's not uncommon, however, for patients to forgo a second opinion for fear of insulting their physician. Set that notion aside. You are in charge of your health; one particular doctor is not. “Many patients think that seeking a second opinion somehow indicates a lack of trust, rather than a desire to confirm what their doctor has told them and explore options their doctor either might not have access to or be aware of,” Linden observes.

How do I make it happen?

There are two paths forward — one with help from your physician, the other without. (Remember: You don't need your doctor's permission to seek a second opinion.) For some patients it's important to go into a secondary consult with a blank slate. If you'd be more comfortable seeing a physician independent of your diagnosing doctor, Linden suggests connecting with others who have received the same diagnosis and asking about their experience. Activist groups, organizations and support societies are all sources for feedback and names of specialists.

But it may be easier for you just to ask your physician for a referral. And enlisting your original doctor in the process will make it simpler to transfer records and test results to your new provider. If you're concerned that the first doctor's opinion might influence the second's, don't be. Physicians receiving patients for a second opinion understand that their job is to reexamine and reevaluate the information independently.

"I consider myself to be an advocate for my patients. I always encourage a second opinion, and I may be able to help them find an expert for their disease and get the appointment as soon as possible,” says Adil Akhtar, an associate professor of medical oncology and hematology at Oakland University William Beaumont School of Medicine in Rochester, Michigan. That's the attitude you want to see in your doctor.

Who pays for it?

The vast majority of insurance programs, including Medicare, do cover second opinions. But the golden rule is to speak with your insurance provider first. For the most part, it will be a matter of finding out the proper protocol to follow within your provider's guidelines. PPO plans provide the most straightforward course of coverage, while managed care and HMO plans may require prior authorization and/or the use of a plan-approved provider.

How do I prepare?

Gather copies of your medical records or have them sent directly to your second-opinion physician. Although it may be tempting to start testing from scratch, any duplication may not be an option, depending on your insurance. Research your diagnosis, know what tests are customary, and be prepared to ask questions (see “Information, Please!” at left).

What do I do if the two diagnoses are significantly different?

If a second opinion has created more questions than answers, you can absolutely pursue a third or fourth medical opinion. Varma says she sought out numerous doctors when her mother, who had a cardiac condition, was also diagnosed with breast cancer. “We needed someone who was comfortable treating the cancer in a way that wouldn't impact my mother's heart,” Varma notes.

"Patients often have better outcomes when they go into treatment with confidence rather than half-heartedly or with worry. So there is value in those opinions, even if they don't shed new light on the treatment,” Linden offers.