By Vicki Rackner, M.D.

A situation all too common for caregivers is the reluctance of loved ones to get a second opinion. For instance, Jody, a caregiver, said, “My mother seems to have a million reasons for not getting a second medical opinion.  She has some good points, and I’m often hard pressed to overcome her objections.”

As a surgeon, I have heard a multitude of similar questions about second opinions. Many people are afraid to get a second opinion, for a variety of reasons. As a caregiver, however, it may be vitally important for you to convince your loved one to receive a second opinion. Here are some questions you may have heard from your loved one regarding second opinions, and some ideas on how to address these questions.

Your loved one asks: Will I hurt my doctor’s feelings if I get a second medical opinion?

My thoughts: We should reframe this question. Will you hurt yourself and your health by not getting a second medical opinion? You want a doctor who makes your interests the top priority.  After all, the health care system serves patients. You are the guest of honor.

You might respond to your loved one: “Mom, I care more about you than the doctor’s feelings,” or “Doctors understand that second medical opinions are recommended.” You could also say, “Your doctor would get a second opinion if he was in your shoes.” If your loved one is still hesitant, say, “Your health is too important. Let’s get a second opinion just to be sure. I’m sure your doctor will understand.”

Your loved one asks: Do I have to tell my doctor I’m getting a second opinion?

My thoughts: In an ideal relationship with your doctor, you would say, “I’m going to get a second opinion to be 100% sure,” or “Could you refer me to a doctor who sees patients with my medical condition all day every day? Maybe we can learn some tips that will help us manage my health.” Or you can simply tell them, “Other healthcare providers insist I get a second medical opinion.”

However, many people shy away from second opinions because they cannot imagine saying these words to their doctor, or their loved one’s doctor. If you are one of these people, don’t worry. You can get a second medical opinion without saying anything to your doctor.  Your doctor does not need to know.

You respond to your loved one: “No, we don’t have to tell your doctor if you don’t want to.” Reassure your loved one that their doctor will not find out, and that they are not “going behind their doctor’s back.” They are merely making a sound decision to get as much advice as possible.

One thing to keep in mind: If it’s hard to tell your doctor you’re getting a second medical opinion, I invite you to consider whether this is the best doctor for you.

Your loved one asks: Does getting a second medical opinion mean I don’t trust my doctor?

My thoughts: Sometimes when pruning my apple tree, the branches I could see so clearly from a distance were hard to identify when I was right under the tree. Getting a second medical opinion is like standing back from the tree and gaining perspective. 

You respond to your loved one: “Of course you trust your doctor! A second opinion will reaffirm this trust.” 

Your loved one asks: What if this new doctor has a different opinion than my doctor?

My thoughts: Wouldn’t you rather know now before you travel down the wrong medical path? 

This is when your “quarterback doctor,” your primary doctor who calls the plays for your big health picture, comes in handy.  This doctor can get on the phone and sort out why the doctors have different opinions, translate the concerns to you and your loved one, and help you guide you through the medical choices that best serve you and your loved one.

You respond to your loved one:  “I realize if the second doctor has a different opinion, it could put you in an uncomfortable position. But we can always go back to your primary doctor and have a conversation about the different opinions, and see what he or she recommends. It is better to know if something might be wrong or different now.”

Your loved one asks: Am I going to harm myself by waiting for a second opinion?

My thoughts: In most situations it is perfectly safe to wait a week or two before getting a second medical opinion.  You can ask your doctor, “Is this a medical emergency, or do I have time to consider my choices for a week or so?”

You respond to your loved one: “Let’s ask the doctor!”

Your loved one says:   My primary care doctor tells me, “You don’t need to see a specialist.  I see patients with this condition every year.” 

My thoughts: A doctor who says this may be putting his or her pride above the best interests of your loved one. 

The doctor who sees lots and lots of patients with a narrow scope of medical conditions may be better informed and may have more pertinent clinical experience with that condition.

A doctor who discourages you from getting a second medical opinion raises a red flag; you may have to consider changing doctors.

You respond to your loved one: “It sounds like the idea of a second opinion hurt the doctor’s pride.  I care more about you than your doctor’s feelings. Perhaps we should consider switching to a doctor who has your best interests at heart.”

Your loved one asks: Is a second opinion really worth the trouble?  Every time I see a doctor you have to miss work and make lots of phone calls.

My thoughts: Yes, getting a second medical opinion requires some effort.  You need to find a doctor, collect your medical records and tell your story all over again to a new doctor.  However, when you weigh this against the trouble of going down the wrong medical path, second medical opinions are well worth the time and trouble. 

You respond to your loved one: “Mom, I love you and I want you to get the best care possible.  I see a second medical opinion as a good investment of time and energy.”

Your loved one says: I don’t want to get a second medical opinion.

My thoughts: You want to help your loved one take the most direct path from illness to health, and enjoy an optimal quality of life.  Second medical opinions can help accomplish both.

You respond to your loved one: “I hear you. I think it is a good idea, and so do other doctors. Please reconsider.” Then let them make their own decision, and be sure to respect that decision even if they decide not to pursue a second opinion.