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Getting A Second Opinion

When we visit a physician concerning a medical problem we are experiencing, we will receive that doctor’s evaluation and recommendations.  Often, the problem(s) are fairly straightforward/simple and the evaluation and recommendations are quite easy.  As an example, if a person is experiencing several days of frequent urination, burning on urination and urinary urgency, the evaluation is a simple urine analysis/culture and the recommendation will most likely include an antibiotic that covers the most likely urinary tract bacterial pathogens.  Is a “second opinion” needed?  That would be superfluous and highly doubtful.

However, there are other situations when the symptoms/disease are much more complicated.  An example of this would be a male that has a prostate specific antigen  (PSA) that is elevated, an MRI shows some areas that are abnormal, and a biopsy shows prostate cancer.  The doctor may recommend surgery vs. radiation implants as the therapy of choice.  Both of those treatments have their own risks/benefits and these must be carefully evaluated.  After receiving the recommendations of one doctor, it may make very good sense to obtain a second opinion to either confirm/refute the first doctor’s recommendations.

If you see a physician and inform that doctor that you wish to obtain a second opinion and that first doctor seems annoyed or dismissive of you, this is a red flag.  As physicians we should all not feel belittled or threatened by patients that want to listen to a different viewpoint.

The more serious the medical issue and/or the more invasive/risky the therapy will be, the more a second opinion (and perhaps a third one as well) is strongly advised.  Please view your doctors as consultants, i.e. they are there to provide you with a professional/expert opinion as to what is causing your symptoms and what will be the best tests/treatments to have.  YOU are ultimately the decision maker as to what path you will take.  Obtaining a second (and perhaps third) opinion allows you to make the best choice for yourself or family member.

Being a primary care general internal medicine physician, I would defer to specialists as to what would be the best treatment strategy for people with serious issues related to that particular specialty.  However, I often have patients run things by me just to get my opinion.  At times, I have found surgeons being a bit too aggressive in their surgery recommendations and advised the patients to seek a different surgical opinion, but this time, I arm the patient with a bunch of specific questions that were not asked/answered during the first doctor’s visit.  

And I will end this with a  very funny Rodney Dangerfield line:  “I went to a doctor for a second opinion about my need for a vasectomy…He said that with your face, you don’t need one…I get no respect!”

Enjoy some classic Rodney   

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