Five Things you may not Know About Second Opinions, from the Harvard Health Letter

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Getting a second opinion about a medical issue can confirm a previous diagnosis or offer new insights, and may help avoid costly or unnecessary treatment.

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Most people face at least one major medical decision in their lives. Sometimes the treatment choice is clear-cut—but when it isn’t, getting a second opinion is recommended, notes the October 2011 issue of the Harvard Health Letter.

Second opinions can lead to less expensive tests and treatments, so insurers have an incentive to allow—and may even encourage—second opinions. But the Health Letter editors advise insured patients to check with their health plans to make sure the consultation and any associated services are covered.

Here are five other observations about second opinions from the Health Letter editors:

1.    They’re less common than you think. A recent poll showed that about 70% of Americans don’t feel compelled to get a second opinion or do additional research.

2.    Your doctor won’t be mad. It can feel awkward to bring up, but doctors generally welcome having their patients seek second opinions. “If you have a doctor who would be offended by a second opinion, he or she is probably not the right doctor for you,” says Dr. Gregory Abel, a blood cancer specialist at Harvard-affiliated Dana-Farber Cancer Institute.

3.    You may need to make your priorities known. Although your primary-care physician may know you well, a specialist providing a second opinion may not—at least not at first—and may focus on different aspects of the treatment. In a study published last year, investigators asked a group of patients and providers to rate facts and goals around treatment choices for early-stage breast cancer and found several areas of disagreement. For example, patients were more likely than providers to focus on possible side effects.

4.    The first opinion may affect the second. Researchers based at Ben-Gurion University of the Negev in Israel recently surveyed hundreds of orthopedic surgeons and neurologists to explore whether second opinions are influenced by the first ones. After distributing hypothetical patient scenarios, they found that orthopedic surgeons were more likely to recommend a more “interventionist” treatment if they knew the first physician had advised one, and they leaned toward a more conservative approach if the patient hadn’t yet received an opinion. However, no such effect was found among the neurologists.

5.    You may need to bridge a communications breakdown. According to ongoing research by Dr. Abel and colleagues, about 20% of patients are sent to see a specialist without any formal communication from the first doctor. So prior to their appointment, patients should contact the office of the doctor providing the second opinion to see what medical records they should bring with them or have sent.

Read the full-length article: “A matter of opinion”

Also in this issue:

  •     The science of taste, appetite, and eating
  •     Hospital delirium and how it can be prevented
  •     Q & A with orthopedic surgeon Dr. Donald Reilly
  •     Fecal transplants: A novel therapy for Clostridium difficile infections
  •     Antidepressants and cataracts
  •     Unconscious vs. subconscious: Which is the correct term?

The Harvard Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $29 per year. Subscribe at http://www.health.harvard.edu/health or by calling 877-649-9457 (toll-free).

Media: Contact Raquel Schott for a complimentary copy of the newsletter, or to receive our press releases directly.

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