Second Opinions - How to Get One?
By Davis Liu, M.D.

What is the best way for a patient to approach her doctor about getting a second opinion?

The best way is to tell the doctor that you appreciate his care, and for to proceed further it would help you to get a second opinion to see if there are other alternatives or ideas. If you aren t the one wanting the second opinion, but it is a family member, then I would suggest that you tell your doctor that it is your loved one that is requesting it. Reassure the doctor that you wish to continue care with them, but wanted to explore the possibility of other options.

Good doctors shouldn t be offended. If they are comfortable with their diagnosis and treatment plan, they know that you aren t likely to find alternative therapies. Good doctors also know that they don t know it all and they welcome the opportunity to learn something new from a second opinion. Finally doctors are notorious for asking for second opinions when they are patients, as they all understand some of the uncertainly of practicing medicine, and aren t shy about asking for one. It is your health. Having regret of not asking for a second opinion is worse than having to perhaps bruise an ego. Again, good doctors aren t offended, often expect to be asked for second opinions, and will suggest a patient get a second opinion in a particularly serious medical condition.

What should patient and doctor discuss under these circumstances? Please give examples of what to say.

Say that you very much appreciate their care and value their advice. You wondered if there were alternative treatment options or therapies that other doctors might be familiar with that he would recommend for a second opinion. Reassure the doctor that you will be coming back to his practice and this request is simply more for your piece of mind, or that of your loved one. Explain that you are very satisfied with his care.

Don t demand a second opinion. If your doctor won t help you, you can still get a second opinion. You might also want to consider switching doctors as a doctor who won t help you get a second opinion, particularly for a potentially serious medical problem, may be more worried about his ego rather than putting you first as a patient.

How can a patient best get his primary care doctor on board if the patient decides to go a route not recommended by his doctor?

Patients need to realize that much the same way doctors can t force patients to do certain things, like exercise more, lose weight, quit smoking, and take prescription medications, that they also can t force their primary care doctor, whether an internist or family physician, to get on board to an alternative treatment plan. If their doctor wishes to work with them and both parties can compromise, that would be great. If not, it is best that the patient find another doctor they can work with.

Doctors are available to provide patients their medical expertise. Depending on the doctor, his experience can vary widely. Rather than trying to force a primary care doctor to get on board to a plan he doesn t agree with, it would be better to find another doctor with the expertise you need.

Davis Liu, M.D., is a practicing board-certified family physician. He graduated summa cum laude and Phi Beta Kappa from the Wharton School of Business at the University of Pennsylvania. He received his medical degree from the University of Connecticut School of Medicine. His book, Stay Healthy, Live Longer, Spend Wisely - Making Intelligent Choices in America s Healthcare System, is available in bookstores. Autographed copies are available direct from the publisher.

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