To Your Health: Second opinions can have impact on treatment plans

By Alfred Casale - To Your Health
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If you’re concerned about a health issue or are facing a new diagnosis, you might have a lot of questions. Even if you fully trust your doctor — whether it’s your primary care physician or a specialist — it may be helpful to meet with someone who can review your options or explain them in a new way.

In other words, don’t be shy about seeking a second opinion.

When it comes to an unusual or serious diagnoses or complex treatment plans, patients often want to be sure that they are getting the best care. Requesting a second opinion is a great way to see what else is out there without having to put your current treatment plan on hold.

Requesting a second opinion isn’t all that common — over 70 percent of patients report that they don’t even consider it. However, when people get a second opinion, it can have an impact; nearly 10 percent of patients who get one elect to change their treatment plan.

One of the biggest reasons people hesitate to seek out a second opinion is they are concerned the decision will upset or offend their doctor. Trust me on this one; if your provider gets angry or upset by your request, maybe you need a new provider. I know of no quality physician who wouldn’t welcome the confirmation of their plan by another pro.

Most doctors welcome a second opinion because it gives them a chance to hear a new perspective. Even though they may not be swayed by a second assessment, hearing someone else’s interpretation can spark new ideas.

By getting a second opinion, you may be able to avoid the wrong treatment, confirm a correct diagnosis or just find more peace of mind. Beyond that, doctors and health systems have access to different clinical trials and experimental treatment options, which you may want to consider, if necessary.

Be careful, though, that you choose an appropriate person to render the second opinion. Get advice from your doctor, your other specialists and people familiar with the medical community here and afar. Don’t troll the internet looking for flashy, self-promoting practitioners who promise things way out of line with reality.

In fact, your current doctor may have a peer at another hospital or in a separate department that they would like to recommend. In many cases, another specialist within the same integrated delivery system or institute can access your records easily and efficiently. In fact, a real advantage of having a doctor who is part of a larger system is that they can readily get the input of peers either formally or informally by presenting your case and reviewing your studies at group conferences within their system.

I’ve been very fortunate to have always practiced in that sort of environment. That way, my patients don’t just get the benefit of my input, but of the collective experience of many cardiac surgeons and cardiologists from many backgrounds. The routine availability of these “curbside consults,” or multi-disciplinary conferences, is a major plus of group practices and is usually provided at no cost to the patient.

Some patients may want to see a second or even a third physician in formal consultation but may be unaware of the costs associated with this, or the amount of time that it will take to make the necessary arrangements.

How to get a second opinion

If you’ve decided to seek out a second opinion, the first step is to inform your first doctor about your decision.

You will also want to consult with your insurance provider. Most plans cover second opinions for major procedures or surgery as long as they are in-network, but may not cover second opinions for prescriptions or less-complex medical issues.

Your doctor will then have all of your medical records and test results sent to the second physician. Ideally, after reviewing your case, the two providers can have an open conversation on their diagnoses or recommended treatment plans.

Following the appointments, you may end up with different diagnoses or treatment options. It will be up to you to choose which you think is best, typically based upon your medical history, personal values and treatment goals, but only after you have a clear and thorough understanding of the rationale and reasoning of your team.

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By Alfred Casale

To Your Health

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]