Getting a Second Opinion

Your doctor has just told you that you have cancer. Your mind is racing. You have many questions for your doctor. One may be, “Should I get a second opinion?”

A second opinion is when another doctor gives you his or her opinion on your condition. Kenneth Anderson, M.D., professor of medicine at Harvard University and director of the Jerome Lipper Multiple Myeloma Center at the Dana-Farber Cancer Institute in Boston, believes that second opinions are important. Anderson said that since the field of medicine is always changing, it's good to see another doctor for a second opinion. He is used to people coming to him for second opinions; Dana-Farber is one of the most well-known and respected cancer centers in the world.

“New advances in medicine occur rapidly and are sophisticated. It's difficult for any one person to be an expert. Patients need to be aware of and seek out doctors who are focused on their condition,” he said.

When Is a Second Opinion Necessary?

The decision to get a second opinion may be up to you and your family, or it may be up to your health insurance plan. Many health plans require their members to get a second opinion before they will cover care. Some health plans only cover a second opinion if the member asks for one. Before you seek a second opinion, be sure to check with your health plan about their policy on second opinions.

You may want (or need) to get a second opinion if your doctor recommends non-emergency surgery or a serious treatment, such as chemotherapy. You may also decide to get a second opinion if you do not feel comfortable with your doctor, the diagnosis, or the treatment plan.

“You have to be confident with the person who will provide your care,” said Anderson. “If you have any doubts, you should get a second opinion.”

You should receive immediate care and postpone looking for a second opinion, however, if you need an emergency procedure. You can always look for a second opinion later.

“Any type of cancer can have complications, such as high blood calcium,” said Anderson, “That needs to be taken care of immediately. But it doesn't mean that you can't get a second opinion for a treatment plan for your illness. Emergencies take priority.”

Anderson also added that some patients get caught up looking for opinions about their condition. This may postpone care that they need to get.

“Seeking out alternative opinions can be nonproductive and can even be counterproductive,” said Anderson. “It can also be confusing and create needless anxiety. Once you have a good doctor, stick with him or her.”

Telling Your Doctor

Once you've decided to get a second opinion, you may worry about telling your doctor about your decision. According to the American College of Surgeons, “Second opinions have always been part of good medical practice.” The Food and Drug Administration describes a second opinion as a “time-honored practice.” Anderson added that second opinions are “routine” in medicine today.

Second opinions are also your right as a patient. According to the American Medical Association's policy on second opinions, a doctor should recommend a second opinion if he or she thinks it would benefit your care. Your doctor should give the second doctor your medical records and any suggested treatment plans. This will help the second doctor form his or her own opinion about your condition.

It is also improper for the first doctor to end his or her relationship with you if you decide that you want a second opinion. If your first doctor is offended that you want a second opinion, you may ask yourself if this is the right doctor for you.

One benefit of telling your doctor that you'd like a second opinion is that he or she can help you find another doctor for a second opinion.

“Be very open with your doctor,” said Anderson. “Enlist him or her to suggest who or where you can get the best second opinion.”

Finding a Second Opinion

With the explosive growth of the Internet, Anderson added that it's easy for people to find doctors and medical centers for the best care for their condition. The Internet has also helped people find others with the same medical condition.

“Patients share information,” Anderson said, “They talk on the Internet and it's easy for them to find centers of excellence.”

Besides using your doctor as a reference source, you can contact your local medical society, hospital, medical school, or health plan. The Cancer Information Service is a toll-free service that recommends cancer treatment centers, including ones supported by the National Cancer Institute. You can reach them at 1-800-4-CANCER (1-800-422-6237) or visit their web site at www.cancer.gov .

The American Board of Medical Specialties (ABMS) Directory of Board Certified Medical Specialists lists doctors, their specialties, and their educational background. If a doctor is certified by the ABMS, it means that he or she has had years of residency training, specialty practice, and has completed an extensive specialty exam. You can find the directory at your local library, or view it online at www.abms.org .

While researching doctors, it's also important to note if a surgeon is a fellow of the American College of Surgeons. A fellow has the letters “FACS” after his or her name and title. A fellow is considered “professionally competent and ethically fit” by the American College of Surgeons.

Remember that it's your right to seek a second opinion. And keep in mind that research shows that people who are involved in their care often get better results than those who are not.