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When to Get a Second Medical Opinion

Most insurance policies will cover the fee for a second opinion as they would a regular office visit, but check with your insurer.

Your doctor has just diagnosed you with a serious disease, or recommended a costly procedure, or advised you to have major surgery. Before panicking or following a drastic course of treatment, get a second opinion. Not only can a medical evaluation from a different doctor help you learn more about your illness, the options available to you, and the risks and benefits of each path, but it can also “give you the confidence and peace of mind that you’re making a good decision,” says Robert Nielsen, medical director of PinnacleHealth System in central Pennsylvania.

Most insurance policies will cover the fee for a second opinion as they would cover a regular office visit, but it’s always wise to check with your insurer before you schedule the appointment, especially if you plan to go out of network. “In some cases, such as certain elective surgical procedures, a second opinion is mandatory,” says John Ulatowski, vice president and executive medical director of Johns Hopkins Medicine International, in Baltimore.

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Ask for referrals from people you trust—your primary care physician, the doctor who delivered your first opinion, your family and friends. Avoid seeing a colleague at the same practice or medical center as the doctor who gave you the first opinion—the approach to care can vary from place to place. For example, “some cancer centers are more aggressive about treatment; others are more concerned about side effects,” says Jerome Groopman, Recanati Professor of Medicine at Harvard Medical School.

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For cases that involve a specific procedure—for example, heart-valve replacement surgery—consult a doctor who frequently performs those surgeries. “The more advanced and risky the treatment, the more important to seek the center where doctors have a clear expertise in it,” says Ulatowski.

Whenever possible, see the doctor in person. That may not be necessary if all you need is a second set of eyes on the lab-test results or MRI. But generally, nothing beats a face-to-face visit with a doctor. “The full value of a second opinion includes a physical assessment and discussion with the patient,” says Ulatowski.

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Ask the right questions. Pose these basic questions at your visit: What does the disease mean for my health? What is the natural progression of the disease? What does it mean if I do or don’t have the recommended procedure? What are the other options, and what are the pros and cons of those options? Although you may have covered the same topics with your first doctor, most patients absorb just a fraction of what any physician tells them, especially if it involves bad news. “It never hurts to hear the same information again,” says Ulatowski. Bring a friend or family member with you to help you understand (and remember) the doctor’s advice.

If you end up with two different opinions, don’t assume that the first opinion is wrong. Go back to your first doctor and share what you’ve learned. “People think medicine is standard and there’s only one answer, but many times there are multiple answers to one situation,” says Nielsen. A good doctor will consider the other opinion and try to reconcile the differences for you. If she doesn’t, consider getting a third opinion.

Be sure, however, that you’re not simply seeking the answer you’re hoping to get. Groopman made that mistake years ago. Instead of heeding expert opinions that surgery would do little to ease his back pain, he says, “I shopped surgeons until I found one who told me what I wanted to hear—that he could fix me.” Groopman had the surgery, but the pain lingers.

Whatever you do, don’t procrastinate. It takes time to get more opinions. And, says Nielsen, the risk of waiting can outweigh any benefits.

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