You sit there feeling devastated as you’re given the diagnosis. You barely have time to let that sink in before your doctor starts recommending a complex procedure and going over the possible complications. You hardly hear what is being said as your mind races from the news you just received. Life can get surreal as it changes in a New York minute. You don’t know what to do. Do I really need this surgery? Could I be worse after surgery? Is this the best treatment option for me? Is the doctor just doing this to make money? Does this doctor have a clue what they’re doing?! You can’t help yourself as these thoughts race through your mind, wondering what to do next. But now you are being asked by your doctor what you’d like to do. You don’t know what to do, where to turn and who to trust. The same applies if you are being treated for a condition and not getting any better. When is it time to get someone else involved in your care? Aren’t two heads better than one?
Take a Deep Breath
During my internship, we had rules for a code blue. A code blue was what went out over the hospital intercom when a patient needed immediate CPR. We would charge ahead, sprinting down the corridors to get to the patient’s room, hopefully, to save their life. Rule #1 when you got to the patient’s room, CHECK YOUR OWN PULSE. You cannot make good decisions when your mind is reeling. The same is true when you receive a diagnosis. Everyone gets thrown for a loop when they get unexpected news, and medicine is no different. Take a deep breath and try to calm yourself. Unless your situation is life-threatening, you shouldn’t have to decide on the spot. Take some time. Write your questions down and ask your doctor when you are in a better state of mind. I try to end all of my patient’s visits the same way, “Do you have any questions?” Most of the time, the answer is no. Yet patients tell me all of the time that they thought of several questions on the way home they wish they would have asked. If you find yourself in that situation, pick up the phone and call your doctor. Ask questions.
What If You Still Have Questions?
What if you still have concerns or are not comfortable with the answers? Get a second opinion. Doctors are no different than anyone else. We all make mistakes. All doctors have different skill levels and areas of strength and weaknesses. We, as professionals, know this and understand the plight that patients are going through. You should feel reasonably comfortable with the answers from your doctor. If not, ask again. If still unsatisfied, get a second opinion. Patients sometimes feel that asking for a second opinion is insulting to the doctor and are afraid of offending them. No good doctor should have any problem with a patient asking for a second opinion if done appropriately (more on that, later). If your doctor dismisses the idea, scoffs at the thought, or tells you that you are wasting your money, then you should proceed with caution. Any good doctor will put your welfare first and welcome a second opinion, even if their ego gets bruised slightly.
How Do You Ask for a Second Opinion?
I’ve often heard that second opinions are worthless since all of you doctors are in it together. “You’ll just agree with each other so you can all make more money.” Nothing could be farther from the truth. Doctors compete with each other for patients. As long as you are not seeing the doctor’s partners in the same group, you should get an unbiased, independent opinion. When asking for a second opinion, make sure you see a doctor in the same specialty. Let’s say you want a second opinion concerning possible cataract surgery. See an ophthalmologist trained in cataract surgery rather than your primary care provider. If the second opinion doctor agrees with the first doctor, it is a common courtesy to return to your first doctor for treatment. Beware of second opinion doctors trying to “steal” patients. Statements like, “your first doctor is entirely wrong; only I can fix this problem” should raise concern. If you get entirely different opinions, ask each doctor to explain their recommendations in more detail or even get a third opinion.
When Not to Get a Second Opinion
Some situations make getting a second opinion dangerous. If you have an emergent or life-threatening condition, time is of the utmost importance. If your doctor sends you immediately to the emergency room or cancels the rest of their office to take you to surgery, do it! You need time to get a second opinion, which you do not have in an emergency. Many years ago, my father was going to get his hernia repaired just before retiring. He figured that he would use his company’s insurance one last time. At his preop physical exam, his doctor noticed a little something unusual on his EKG. By 5 o’clock that evening, he was in the operating room getting a 4-way heart bypass. He went on to live a full life for 15 more years. If, at any point that day, he would have said, “Let’s hold off on everything until I get a second opinion,” we would have attended his funeral later that week instead. Treat emergencies differently.
This newsletter does not constitute medical advice. Make sure to contact your healthcare provider if you experience any of these conditions. Do not make any changes before consulting your physician.