When to Get a Second Opinion

You are told you have a serious condition that has a complicated treatment and subsequent lengthy recovery process. Your doctor is certain that the treatment he is advising is your best chance of survival, and he urges you to make a decision. But you are hesitant. You have heard of wrong diagnoses, and ill-advised treatment plans that waste time, money, and even leave people worse off than they were previously. Yes, these things do happen. Doctors are human and they make mistakes. So, what should you do when given a diagnosis? Many choose to seek a second opinion to help them determine their plan of action. A second opinion is medical advice from another qualified expert in the field. A second doctor’s perspective may provide you with an alternative treatment suggestion, or even allow you to avoid treatment altogether. 

There are two ways to receive a second opinion: in-person and online. When choosing to see another doctor in-person, you can ask your current doctor for a referral, but this is not required. Always inform the doctor who gave you the first opinion that you are seeking another opinion, so that medical files can be more easily attained. The doctor providing you with a second opinion will need these files. You should not worry about offending your initial doctor with this request, as receiving a second opinion is a common practice. Some insurance companies even require you to seek a second opinion for certain medical diagnoses. Another option is to use one of the many online services that now provide second opinions. This can be especially useful when you do not have easy access to specialists in your area. Some services will also arrange for you to see a doctor in-person if that is what you prefer.

Cost & Some Options for you to Explore

Second Opinions is an online service that provides written, phone, and video consultations. You can upload radiology images, such as MRI, CT, and ultrasounds to their server, and a doctor specializing in that field will review the image and send you a written report. The cost for this type of written report is at least $29.  If you would like a more extensive second opinion within a specific medical field, then you can upload as many pages of your medical file as required for a specialist to review. In this case, you have the option of receiving a written report, phone consultation, or video consultation. The price will vary depending on how detailed you want your report to be, and how many pages your medical file is. This cost ranges from $179 to $349. A $600 written report is also available. For this premium price, you will be receiving a consultation with doctors in one of the leading United States’ hospitals. 

Some hospitals themselves also provide an online service. Cleveland Clinic charges $565 for a written second opinion. An additional $180 is charged if a pathology review is required. This hospital does not accept insurance payments, but you may qualify for reimbursement under your employer’s benefit program. You will need to verify with your employer if you are covered. 

Grand Rounds is another online service that you can use. It is significantly more expensive than Second Opinions, and has a single fee of $7,500 for a written opinion. The company can also arrange for you to see a specialist in-person for a cost of $599. This charge only covers the appointment booking, and the visit itself is subject to an additional charge if your insurance is not accepted. When arranging the appointment, they will seek out leading doctors who will be covered by your insurance. Check with your employer before disregarding the service due to price, as Grand Rounds’ second opinion fees are covered by some benefit plans. 

What to do When Your Second Opinion is Different

A second opinion is designed to help make your choice easier, but sometimes you are left even more confused than when you started. It will make sense to take your initial doctor’s advice if the doctor providing the second opinion agrees with the diagnosis and treatment suggestions. The situation becomes complicated when there is a disagreement. Who do you listen to if the second doctor suggests a different method of treatment, or even gives you an entirely different diagnosis? To make the best decision for yourself, you must first determine the answers to these questions:

  • Which doctor has more experience?
  • What is their success rate?
  • Who is more confident in their diagnosis?
  • What support does the doctor providing the second opinion use to disagree with the initial diagnosis and/or treatment suggestions?

Some people choose to seek a third opinion when they still feel uneasy making a decision. This could be helpful in providing you with a more definitive choice. Always check with your insurance company to determine coverage. Just because the second opinion was covered, does not mean that the cost of the third opinion will be.

Are Second Opinions Biased?

You seek a second opinion because you genuinely want another professional to consider the facts of your situation and provide independent advice. Several studies have found that this may be difficult to achieve in practice. One study in 2010 indicated that almost two-thirds of the surveyed oncologists believed their second opinion was influenced by the suggestions of the first doctor. Various possible motivations were given for this occurrence, including the desire to provide certainty to the patient. At least one-third of the oncologists in the study also stated that even their relationship with the initial doctor influenced their opinions. Doctors were concerned with how they would be perceived by their peers based on the opinion they gave. 

Given such data, the benefits of receiving a second opinion become less clear. That so many doctors were aware of their bias on a conscious level should be taken into account when coming to a decision. This should mostly affect those who have no coverage and are forced to pay for a second opinion out-of-pocket. If your insurance or employer covers the consultation, then there is little to lose. Keep in mind that the implicit, unconscious biases of the doctors were not examined. It is also important to note that the studies surveyed oncologists—doctors who treat cancer patients. This same dynamic may not be found in other fields of medicine.

Should You Question Your Initial Diagnosis?

Ultimately, you should determine if your situation warrants seeking a second opinion. If you are not confident in the initial diagnosis and recommendation, it would be worth it to seek out a second opinion to hopefully provide more peace of mind when deciding a treatment option. While the cost can be significant, this may be mitigated by your insurance or employee benefit plan. Time is also an important factor. If you have a serious condition that needs to be treated immediately then it may be harmful to delay making your decision. Remember to not be concerned with hurting your initial doctor’s feelings. Doctors are professionals, and understand the importance of health care decisions. 

Many doctors actively encourage their patients to seek a second opinion. There are some concerns of bias affecting the second opinion industry, but this should not alone discredit the practice. We often take our health for granted until we experience illness, and then recovery becomes a priority. Second opinions can be an important tool in that process.