Why You Shouldn't Hesitate to Seek a Second Medical Opinion
If something doesn't smell right, have someone else smell it
Have you ever opened a gallon of milk approaching the expiration date? You take a big whiff to see how it smells, and you’re not really sure. So you take a sip.
Next thing you know, you’re drinking curdled smelly milk chunks, wishing you’d had your spouse take the first sip instead.
That’s how I think about medical diagnoses.
There are a lot of good doctors out there. Unfortunately, they can be difficult to find. As a result, many people are stuck with terrible doctors. Their bedside manner sucks, their appointments are never on time, you don’t feel comfortable with their treatment plan, whatever.
Most people stick it out because, “Eeh the next closest doctor is 30 minutes away.” That’s fine for your run-of-the-mill medical issues. If you just need someone to prescribe the occasional medicine or order blood work, who cares.
Now, imagine that same doctor diagnoses you with a serious, life-threatening disease. Or one that requires surgery. Or one that rhymes with dancer.
Don’t mess around with these types of diagnoses. You need to be sure about what you’re dealing with, or else you’ll suffer the consequences in the long run. Nobody wants to be treated for the wrong disease or have the wrong surgery. Unfortunately, many do.
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Asking for a second opinion doesn’t necessarily mean you think your doctor is wrong. They may even be a great doctor overall. The reality is, we all have our strengths and weaknesses. If something is outside your doctor’s wheelhouse, a second opinion can put your mind, as well as theirs, at ease.
This is not an exhaustive list, but here are some things you should consider getting a second opinion on:
Cancer Diagnosis – except for perhaps skin cancer, you should be getting a second opinion on all cancer diagnoses. The reason for this is many doctors have very different treatment modalities and capabilities. If one doctor uses newer technology, your survival odds may be drastically different. They also have very different risk/reward profiles. Some will advocate early chemo, some won’t. Some will wait, and some will operate early. It’s highly variable.
Orthopedic Injuries – “When you’re a hammer, everything looks like a nail.” This applies to orthopedic surgeons. Their job is to diagnose and treat musculoskeletal injuries through the least invasive means possible. Unfortunately, many times they jump right to surgery. This is a function of their training. For that reason, it may be beneficial to find a non-orthopedic surgeon for a second opinion. PM&R, Osteopathic physicians, and physical therapy may be a good place to start. They will likely focus more on things you can do without the knife first.
General Surgery – This is a bit more controversial. There are plenty of surgeries that don’t need to be done, but they are. Again, hammer and nail. Appendicitis is one example. When the appendix becomes inflamed, there are a few different paths it can go down. It can burst, it can become inflamed, it can become infected, etc. Without any treatment, this may or may not resolve without surgery. Then the decision is whether to take it out after the fact. Again, risk tolerances are different depending on the physician.
Medications – This is often overlooked. When you’re on 5-15+ different medications, the number of potential drug interactions is tremendous. Your doctor is the one who put you on all these drugs so they are usually hesitant to take you off. Having a second doctor, or even a pharmacist, take a look at your med list for drug interactions can make all the difference.
Blood Work – Some doctors really suck at analyzing blood work. I am guilty of this myself. I can’t interpret sex hormones (estradiol, estrogen, etc.) as well as I wish I could because I simply don’t do it that often anymore. Most doctors will simply look at the little chart provided on your blood work and scan for anything irregular (it’s typically starred or in red so it’s really easy). It may be best to go to an expert in the field, rather than a generalist. If you’re in menopause, an OB/GYN will probably be better than your PCP, for example.
Again, this is not a comprehensive list. There are plenty of other reasons to get a second opinion. If you are simply not comfortable with your diagnosis or treatment plan, ask for a second opinion.
There are studies showing the treatment plan or diagnosis changes a significant percentage of the time when patients request a second opinion. This should make it clear that doctors aren’t always right and don’t always agree.