How to Ask for a Second Opinion

Family Health, Healthy Living, Power to the Patient
on October 28, 2011
Man at doctor's office.

The Harvard Health Letter discusses second opinions and the role they play in advocating on behalf of your own health. Health Letter editors offer these five observations about second opinions:

  1. They’re less common than you think. A recent poll showed that about 70% of Americans don’t feel compelled to get a second opinion or do additional research.
  2. Your doctor won’t be mad. It can feel awkward to bring up, but doctors generally welcome having their patients seek second opinions. “If you have a doctor who would be offended by a second opinion, he or she is probably not the right doctor for you,” says Dr. Gregory Abel, a blood cancer specialist at Harvard-affiliated Dana-Farber Cancer Institute.
  3. You may need to make your priorities known. Although your primary-care physician may know you well, a specialist providing a second opinion may not—at least not at first—and may focus on different aspects of the treatment. In a study published last year, investigators asked a group of patients and providers to rate facts and goals around treatment choices for early-stage breast cancer and found several areas of disagreement. For example, patients were more likely than providers to focus on possible side effects.
  4. The first opinion may affect the second. Researchers based at Ben-Gurion University of the Negev in Israel recently surveyed hundreds of orthopedic surgeons and neurologists to explore whether second opinions are influenced by the first ones. After distributing hypothetical patient scenarios, they found that orthopedic surgeons were more likely to recommend a more “interventionist” treatment if they knew the first physician had advised one, and they leaned toward a more conservative approach if the patient hadn’t yet received an opinion. However, no such effect was found among the neurologists.
  5. You may need to bridge a communications breakdown. According to ongoing research by Dr. Abel and colleagues, about 20% of patients are sent to see a specialist without any formal communication from the first doctor. So prior to their appointment, patients should contact the office of the doctor providing the second opinion to see what medical records they should bring with them or have sent.