You’ve Decided to Get a Second Opinion, Now What?

Second opinions make all kinds of sense. Here’s my advice on what to do with them.

Doctors are not superhuman. They can only rely on the information they have learned and experienced to make the most educated decision. What’s more, doctors have different practice styles . While one doctor recommends more conservative treatments, another physician might be more aggressive and would advise surgery when there are less invasive alternatives. This is why medical second opinions have become essential in health care, where misdiagnosis and improper treatment can, unfortunately, occur.

A 2014 study from the Mayo Clinic suggests that one in six patients seek a second opinion and in cancer survivors, research has shown that more than half had obtained a second set of eyes. In fact, many insurance plans require second opinions for specific conditions, appreciating that early accurate diagnosis is a catalyst for a decrease in cost of care.

Researchers also found that 66% of patients seeking a second opinion are left with a refined diagnosis and 22% receive a distinctly different or completely new diagnosis. Let’s pause to think about that: One-fifth of the original diagnoses were considered to be wrong — misdiagnosed. That’s quite scary.

When do you need a second opinion?

Small issues in “everyday health care” like colds, cuts, and sprains are unlikely to require another set of eyes because diagnosis and treatment are usually agreed upon by most physicians. It’s the more complex diagnoses such as cancer, risky treatments, surgeries, rare diseases, or persistent chronic symptoms that should trigger further exploration.

Doubt about your diagnosis or treatment plan ( that gut feeling that something’s not right — say, a visit with an overconfident physician who is unwilling to discuss other options ) should also be grounds for fresh eyes.

A study in the American Journal of Medicine found that “the clinical impact [from second opinions] was estimated as moderate/major in 20.9% of cases for diagnosis and 30.7% of cases for treatment.” So in other words, second opinions can improve your health outcomes by changing your diagnosis or treatment for the better. And weighing the options can help you make the best decision for you.

Where to get your second opinion

The first step is finding the right specialist. To ensure an unbiased, fresh and honest assessment, it’s important to choose an independent one who has no association with your current health care team. Share the first opinion with the new specialist to make sure they have all of the information available to render their best advice.

Many times, a self-initiated approach can yield the best results. A simple Google search can find a specialist that focuses on your condition. (Remember: Internet search engines are not a replacement for physician evaluations! While Googling your symptoms can provide information to discuss with your specialist, it should not be used to self-diagnose or treat.)

Academic centers may have physicians with expertise on the cutting edge of treatment, especially in regards to rare diagnoses. Specialty societies for specific conditions or diseases can also be great resources for finding someone. And you can sign up for online health communities such as PatientsLikeMe or HealthUnlocked to ask advice from other people who have had similar experiences. These patients may be able to recommend specialists or health systems that have greatly benefited their care, as well as discuss your options once you’ve been evaluated.

And there are now a number of health systems offering Telehealth solutions. Yale, Massachusetts General Hospital, University of Chicago, Cleveland Clinic, as well as a whole host of other hospitals and independent companies offer remote consultations. Video consults are available in some cases, making the virtual visit more personal. Many insurance companies cover these services.

If you still don’t feel settled after the second opinion, who says you can’t get a third, a fourth, or a fifth? It’s your health and you need to feel empowered to make the decision that is best for you, not anyone else. Be aware, though, that your insurance company may not cover multiple additional opinions so you might have to pay out-of-pocket for further consults.

The big question: Whose opinion do you go with?

Now you have two, maybe three outside evaluations. This is the defining moment of your care, the choice that will lead to your ultimate treatment and, hopefully, recovery. If the second opinion confirms the original diagnosis and treatment plan, then the decision is relatively straightforward. In this scenario, choosing the physician who takes the time to really listen to you can make all the difference.

If the subsequent recommendations differ significantly from the original, the decision will be more difficult, but not impossible with a little help. The Ottawa Personal Decision Guide includes a worksheet and lays out four principles that can help you determine which specialist and treatment plan align best with your needs. You’ll want to consider what matters most to you and what you want to achieve. For some, the risks of treatment may outweigh the benefits, and vice versa: While one patient’s goal may be to live longer, another patient may want to live better by maximizing her quality of life.

One way to safeguard your peace of mind is to engage in shared decision-making with your physician. Instead of the doctor making the decisions and the patient following orders, shared decision-making allows you to weigh the options together. In this two-way process, physicians learn the values, preferences, and needs of the patient while the patient gains the knowledge and expertise of the physician. Patients can even address the items on the decision-making worksheet mentioned above with their specialist to aid in the process. Studies have shown that shared decision-making can “lead to safer, more cost-effective healthcare, which in turn might result in improved health outcomes.”

Eventually, the best opinion is the one you’re willing to accept despite its potential downsides. For example, a doctor recommends a medication with the potential to cure your illness, but that medication has unpleasant side effects. If your main goal is to cure your illness, agreeing to the drug while coming to terms with its side effects, is your best choice.

A final thought: Trust your gut

Exhaustive preparation isn’t always key. In the end, your intuition may be the most important driver in choosing the best treatment. A study in Psychological Science found that intuition can boost decision accuracy and confidence. If you can tune into your subconscious self and trust your gut, you may be more likely to feel great about your choice, in turn giving you the best chance to heal. It’s ironic how you can analyze options until you’re blue in the face, but the choice that provides the most inner tranquility is the one that just feels right.

Have you had experience getting a second opinion? Share your thoughts below…