By Vicki Rackner, M.D.

Jody wanted her mother Maria to get a second medical opinion about her arthritic joints.  Maria’s primary care doctor for more than 30 years had been treating her arthritis for the past eight months. Maria trusted and respected her doctor.  Yet, both Jody and Maria recognized that her joints were not getting better. Maria’s life was increasingly limited by her joint pain and poor mobility. 

When Jody suggested to her mother that they see a rheumatologist for a consultation, Maria grimaced and said, “I don’t think so, Dear.” 

Two more months passed.  Maria now needed help getting up from the couch.  Jody said, “Mom, seeing you in pain causes me pain.  Let’s go and see that arthritis doctor David spoke of so highly.”   Maria responded, “My doctor says he’s doing everything he can.  I don’t want to offend him by going behind his back and sneaking off to another doctor.”

Seeking a Second Opinion

Seeking a second opinion, however, is far from being sneaky. In fact, one of the most powerful interventions you can make as your loved one’s advocate is to seek a second medical opinion. Studies show second medical opinions result in a different diagnosis one out of three times. 

Although seeking a second opinion can lead to a more accurate diagnosis, and possibly, a better outcome, many people believe there us something shameful about getting another doctor’s opinion.  Some statistics say that only one in five patients who goes to a doctor in any given year gets a second opinion. 

I had an insight about second medical opinions as I pruned my apple tree.  Although the apple tree produces apples even if neglected, pruning increases the amount of apples it yields. When I stand away from the tree and get some perspective, I identify branches that need to be cut. However, when I am under the tree, I find it hard to identify the same branches I saw so clearly from a distance. I find myself cutting a branch or two and then stepping back to make sure I'm on track.

Undergoing a medical intervention is much like pruning. Getting a second opinion is like stepping back away from the tree and making sure you're on track. You want your loved one to enjoy the fruits of health. Sometimes, a new perspective is needed. You can often get a better harvest for your health by taking proactive steps.

When to Consider a Second Opinion

Here are some situations that trigger a second medical opinion:

·       The doctor recommends an operation.  Just as pruned branches cannot be re-attached to the tree, so, too, the outcomes from many medical interventions cannot be reversed. Before making any major medical decision, such as surgery, it may make sense to get a second opinion.

• The doctor says your loved one has cancer or some other serious medical condition.  The starting point of a successful medical treatment is an accurate diagnosis.  Creating a treatment plan is like plotting the course of a car trip.  In order to find out the right direction to take you need to know where you’re starting and where you would like to go.  As I stated before, one in three patients who seeks a second medical opinion gets a different diagnosis. These are numbers that make it imperative to get a second opinion before undergoing a drastic procedure. When a doctor gives a serious diagnosis, such as cancer, it is prudent to seek a second opinion.
• Your loved one isn’t getting better.  While it’s true that some medical conditions are managed and not cured, you want to make sure that your loved one is living the best life possible.  Sometimes a second opinion can offer some new resource that could transform the quality of your loved one’s days. Even if your loved one has been stable for some time, new medication and new technologies are released every day.  The question, “Are we doing everything we can for Mom?” is not a one-time question.  Ask it frequently.
• The doctor sees a limited number of patients with your loved one’s medical condition.  No one doctor can keep up with all medical conditions.  Generally, the patients who are seen by a doctor who sees a large number of patients with that diagnosis get the best outcome. Sometimes, a specialist in a specific condition may be able to provide a different diagnosis or treatment. He or she may have more recent information or first-hand experience with a particular condition.
• Trust breaks down.  Trust is a key ingredient in a relationship between a doctor and a patient.  Remember, though, if you are acting as a patient advocate for your father, he is the patient.  Even if your trust in the doctor diminishes, please honor the trust between your father and his doctor.  It’s like a divorced parent honoring the child’s relationship with the other parent.
• A little voice tells you to do it.  Maybe it’s that the doctor just does not seem to be listening.  Maybe it’s that the doctor dismisses a symptom and says, “It’s just old age.” Please listen to that little voice. It is your intuition speaking to you. In my experience, that little voice has something important to say. Don’t ignore your intuition.