If you're received a serious medical diagnosis, you should consider seeing another physician for a second opinion. Not because you shouldn't trust your first doctor, but because you need to become as informed on your illness as possible and different points of view can help you in considering your options for treatment.
The following are seven considerations you should always keep in mind when getting a second medical opinion:
1. Is there agreement?
The obvious and question to begin with is, "Does the second doctor agree with the first diagnosis and the implications of it?" If not, you should consider getting yet a 3rd opinion and even a consultation at a University hospital or academic center.
2. What are the two or three best treatment options?
What are the two to three best treatment options and what are the benefits, risks, and cost of each? Unfortunately, medicine as a business and economic factors often cloud a practitioner's judgment. This is not because they mean to intentionally misguide you, but there are financial incentives involved and you need try to understand their potential influence on the doctors.
3. What if I do the more conservative treatments recommended by my first physician, or nothing at all?
For most medications or medical procedures, presume the risk is a bit higher than reported, as most studies are done in "best case" scenarios. Because of this, if the risk of a conservative approach is really not much higher than the recommended treatment, I personally will tend to choose being conservative. To put this in perspective, my reading of the data suggests that deaths from medications and medical procedures is the fourth leading cause of death in the U.S. — and is largely ignored by standard medicine.
4. In serious cases involving life-prolonging treatment options, what are the differences in quality of life?
In cancer treatments, for example, it isn't enough to only ask whether one treatment will prolong life over another. If the treatment prolongs life by one week, but leaves the patient largely incapacitated for two months when they only have six months of estimated time left, and the treatment leaves the family bankrupt to boot, it may not be something you want to choose. Nonetheless, many physicians have no clue whether a treatment will prolong your life by a week or a year (the drug companies only give them whether there is a statistical difference). Knowing the different benefits expected from different treatment options, particularly when those treatments are likely to be toxic or expensive, is a very important consideration.
5. Bring a friend and a tape recorder with you.
Finally, bring a friend, family member, or other advocate with you during the physician visit, along with a tape recorder. Ask the physician if you can record the visit so that you can review and better understand what they told you. Because of the legal climate, some physicians may be uncomfortable with the visit being recorded, and if this is the case honor their feelings (or the information they give is likely to be so hedged as to be useless). Personally, as a physician, I have encouraged my patients to record their visits for more than 20 years (and had a tape recorder in my office that they could use), as it helped me to give them the needed information more quickly and clearly.
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