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Second Opinions That Don’t Count – or Do

I heard from a friend (I’ll call her Nancy) this morning about symptoms she’s been battling for a few months and was unwilling to share with anyone before now. It seems she has been back and forth with several doctors, has two sets of symptoms that could — or might not — be related. And the bottom line is that both problems will either continue or be recurring. In other words, she’s needing some time now to get on her feet and deal with her new reality.

Her email reminded me of some words of advice from many moons ago — all of which bear repeating. So here you go:

From Nancy, “What I learned is that bad/mediocre doctors are associated with other bad/mediocre doctors who they refer patients to see and good/great doctors are associated with other good/great doctors. It took me time to find the right “group” of doctors that I knew where well informed and were giving me the right answers.”

And my reply, “NEVER ask a doctor to refer you for a second opinion. They have little reason to provide a good referral and every reason for the referral to be unsuccessful. They don’t want to lose you as a patient, so they’ll never send you a competitor who possibly knows more or better than they do. And they are buddies with the people they do refer you to — and a buddy will never contradict a buddy. Those are human attributes, not limited to doctors, for sure.

(Would you ask your auto mechanic to refer you to another auto mechanic? Of course not! He would never send you to his competition because he doesn’t want to lose you as a customer!)

The best referrals are those from other patients who have already been successfully treated. They aren’t easy to find — but you can go to any of the online support groups for your diagnosis and at least chat with others who have your diagnosis and perhaps get good referrals. Support groups are listed here: www.DiagKNOWsis.org/support.htm

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From Nancy, “After second opinions, I finally found an excellent surgeon and he gave me the final word, I did not need any surgery. I had two doctors tell me they thought I would have to have brain surgery and I was preparing to go to either Philadelphia, Boston or Baltimore for second opinions. So it was a long process but I feel very comfortable with the final diagnosis.”

And my reply, “Once you have a second (or third) opinion that differs from the first one, you still need to assess who is right. Just because you like one opinion more than the other doesn’t mean it’s the right one. Just because they recommend an easier treatment, or a less invasive treatment doesn’t mean it’s the right one. And the second opinion isn’t always better than the first — if it was, why would we even seek a first one? ;-)

If you receive differing opinions, then you need to get yet another opinion from someone completely disconnected from the first ones (like in another city) – taking your medical records but NOT a diagnosis with you. It’s up to them to objectively arrive at a diagnosis based on the evidence collected.

One very hopeful sign from your email — you went to a surgeon who told you that you don’t need surgery…. Which is probably correct because a surgeon only makes money when he cuts — so if one tells you that you don’t need surgery, then he must sincerely think you don’t need it.

And then, of course, there is always the possibility of a misdiagnosis – been there, done that. Started a career.”

Sharp patients understand that objectivity is extremely important when it comes to second and more opinions. Doctors are human, and doctors run businesses. When they send you for a second opinion to a friend or partner, it’s because they want the second opinion to agree with theirs — not contradict it. But as patients we want the real story. It’s not about WHO is right or wrong. It’s about WHAT is the right answer, and the best way to take care of it.

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