Health Concerns - When is it Time for a Second Opinion

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There are no hard and fast rules on this one, but these tips can help.

As a provider of specialty surgical treatment for people with knee injuries or knee-related conditions, I am one of those doctors whose services are frequently sought in the capacity of a second opinion for an initial diagnosis or treatment recommendation. Sadly, some come to me with significant guilt for what they think might be a “betrayal” of their original surgeon’s advice. Even sadder, others seek me out with injury or disease progression that has advanced to a debilitating state because the original provider’s treatment recommendations didn’t quite “feel right,” and so the patient waited for … in some cases for YEARS. It shouldn’t be this way. No matter the medical specialty or the recommendations, the ability for people to obtain a second opinion should be praised and celebrated by patients and the medical provider community alike.

First, not every diagnosis or treatment recommendation necessitates a second opinion. This is a very person-specific area of medical care. Simply put, if you feel comfortable with your provider, can trust his or her and their team’s recommendations and care plan, great! You don’t HAVE TO obtain a second opinion.

That caveat is important because the truth is that there is much medical research that has shown that patients who are comfortable and confident in the diagnoses and treatment recommendations from their doctors tend to have better outcomes than those who aren’t. Therein lies the beauty of the second opinion. Trusting in and being comfortable with your doc equals a more favorable health future for you. If you can’t get there with an initial provider, seek out someone else. I must make an important distinction here. The seeking of a second opinion needs to be something YOU want – not a decision a caregiver or loved one talks you into making. This is YOUR health and future, and you must take it into your consideration. Thoughts and advice from friends and loved ones are excellent, but ultimately it must be you who decides.

Once you have decided to seek out a second opinion, one of the most crucial traits to look for is a good listener. Choosing whether or not this is true about a doctor is more art than science, less checklist than gut feeling. Did they ask questions that got to the heart of what is going on with your body? Were they curious about your lifestyle? Especially in the capacity of surgical intervention for an orthopedic condition, as an example, something I need to know about a potential patient is how active a lifestyle they have or want to return to. My treatment recommendations, depending on the condition, may be different for an avid marathon runner than they might be for someone who goes on leisurely walks around the neighborhood. But I can’t make a great decision on which way to go with treatment if I don’t find such things out. Here’s a test for you. If you walk out of an appointment feeling well-informed and clear in your understanding of what’s going on and what to do about it, that’s a great thing. Bonus points if you can easily repeat both the diagnosis and the treatment recommendations to friends or loved ones and they can clearly understand the plan.

Before you hit the second opinion doc’s office, you’ve likely done a bit (or a lot) of online research. It’s important to not walk in with a diagnosis or treatment plan already in mind. In defense of doctors, especially in the case of specialists or sub-specialists, we’ve done a lot of schooling and have likely had some experience under our belts. The Internet can be a wealth of information, but not all of it is accurate, safe, or right for your particular situation. Feel free to share what you’ve researched. But do let the doc do the doctoring.

Speaking of the Internet, there is likely quite a bit of information you can find out ahead of time about the provider you’re planning to visit. One thing to look for is something called a curriculum vitae (CV). This is a fancy term for a doctor’s resume. From that document, you can see where the doctor did their schooling, any specialized training they obtained, as well as research they have been or are involved with — bonus points for those docs that are engaged in current research studies. A doc who is on top of their research often knows the latest advances and recommendations in the field they practice in. This is especially good for patients seeking second opinions.

Finally, I must comment on the topic of surgery. Contrary to what some people think, even we surgeons may not recommend surgery right off the bat, for many conditions. Sometimes a more conservative approach, such as physical therapy, is the next best step. On the flip side, a doctor who has recommended surgery as an initial approach may very well be doing so because the condition or injury in question won’t heal properly on its own without surgical intervention. Again, second opinions can help you feel more confident in treatment recommendations, even if those recommendations aren’t the ones you were hoping for.

As with most things in healthcare, and life in general, there is nuance. In terms of seeking a second opinion for a medical concern, it is so much less about whether a treatment recommendation is a right way for you to proceed than it is about how right it feels to you. Your life, your body, and yes, your choice. The best docs out there do have your best interests at heart and want you to own your health.
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