The days are long gone when we accepted what came out of our doctor’s mouth as the gospel truth. And good riddance, too! There are many reasons why the majority of the population is eager to seek a second opinion. And a third, and a…
Why do patients seek a second opinion?
- Easy Availability: Thanks to the significantly increased number of doctors, there is easy availability of doctors in all hues and specialties in urban and semi-urban areas. There is no shortage of super-specialists, too, in most major metropolitan areas. Referral to specialists and super-specialists is not tightly regulated as in Western countries, and it is possible to meet most consultants at very short notice and, in the majority of cases, as walk-in patients.
- Greater Awareness & Desire to seek better care in the general population: Everybody wants the best treatment for themselves and their loved ones. What has changed from the past is that the current population is much more aware – both in terms of knowledge about the disease and about knowing one’s rights than previous generations. And that is a good thing! This has automatically led to an improvement in the standards of health care in our country. It has forced institutions and doctors to upgrade and improve their skills. Unfortunately, the pendulum has swung too far and, like anything in excess, has been carried too far and completely spoiled the patient-doctor relationship.
- Unsatisfactory or Adverse outcome or course in an illness: It is but natural to seek another doctor’s opinion when things are not going according to plan or if it seems to the patient that their treating doctor is not in control of the management.
Preventing the Need for Second Opinion
My favorite mantra to all patients.
- Research your doctor: If you have the time and are given the opportunity, research your doctor thoroughly before going to one, either on the recommendation of another patient, a doctor, or the first convenient doctor you picked from the internet.
- Don’t do detailed research on your disease: The Internet offers a plethora of information. It is impossible to distinguish the good stuff from the bad stuff. There are many good things there, mind you, but there is a greater amount of misinformation. Even well-known sites have sections containing junk that is just fantasy, a figment of imagination, or the author’s opinion.
If you must research, visit UpToDate and look in the patient section. The official CDC site is also very useful. These are just two of the excellent sites available. But, the vast majority are filled with very iffy information. In any case, you can’t acquire as much information as your doctor. Even for your doctor, it is difficult to remain abreast with all the developments in one’s field. To think that, as a layperson, you will get the authentic information is asking for the moon. - Learn to trust the doctor you choose: Unless and until you feel you chose the wrong doctor, let your selected professional do their job. Medicine has always been an inexact science, unlike arithmetic. In many cases, there are different ways to skin a cat. If you have chosen your doctor well, s/he will ask for a second opinion even before it crosses your mind. A conscientious medical professional freely takes a second opinion when it is in the patient’s best interest. There is no ego involved. With experience, you realize that if one is hung up on ego, you get hung!
You want a second opinion – how do you go about it?
The best way is to ask your treating doctor for a second opinion. As I have already mentioned, a really good and self-confident doctor does not balk at asking for second opinions.
In a large hospital, there are many consultants of the same specialty. Ask around, especially the paramedical staff. They are the ones who have seen the results of all the doctors who visit and can usually suggest the best person available. Beware of two things, though! Sometimes, the paramedical staff get awed by the personalities involved and may be unable to give you an objective opinion. Secondly, it can be very touchy if you zero in on a consultant of the same hospital and the two consultants don’t get along.
It’s better to ask your family practitioner/family member/friend to suggest somebody outside the hospital. Even if it is from the same hospital, you can always tell your treating consultant that my so and so has recommended this doctor. Since things are not going too well, can we take a second opinion? Do hasten to add that you know your doctor is doing their best.
Final words of advice
- Please see the right specialist! Going to the right specialist sounds elementary, but the stimulus for this post was a recent incident.
An infant had been referred to me for constipation, and I suspected a rare congenital cause for constipation and had advised a few investigations. The parents must have had some doubts, so they went back and consulted a pediatrician! The treatment suggested by the pediatrician did not work, so after 15 days, they returned to me. I pointed out to them that they were entitled to a second opinion, but if they wanted one, they should have consulted another pediatric surgeon. - Having one doctor to treat all illnesses is a widespread problem in India. It is a legacy of the days when family doctors were ubiquitous, supreme, and trusted. Now that the urban population prefers to go to specialists, they find a trusted specialist. It does not matter what that person’s specialty is. All problems are brought to that person’s door.
- It is not a problem provided that person has the humility to refer to the appropriate specialist, but all too often, human vanity kicks in.
- Beware! If you ask for a second opinion, you will most likely get a different opinion! As I have alluded to above, Medicine is an Art, and there are many ways to get the job done. I know quite a few doctors find it very difficult to say that I agree with the previous doctor and the recommended treatment. I have seen many prescriptions for second opinions where the prescribed drugs are the same—it is just the brand names that have been changed! If you get a different opinion, you may now be confused.
Is it time for a third opinion? It can go on and on, you know!
