Why You Need a Second Doctor's Opinion

If you're going through a major medical event, it helps to get a backup point of view on what's best for you.
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Sen. Ted Kennedy, D-Mass., received a diagnosis of a brain tumor and subsequently gathered an "A" list of the great and the good experts in the field. Apparently, he asked them to discuss his case in an open forum where opinions were sought and given on his diagnosis and treatment.

Kennedy then made the decision to undergo an operation to remove the tumor. This was considered surprising by many pundits who had assessed the type of brain cancer, reportedly glioblastoma, as almost certainly inoperable.

Seven years ago, I was diagnosed with a malignant melanoma, a potentially fatal form of cancer. I attended the clinic the same afternoon, where the dermatologist removed the melanoma.

I received my diagnosis and immediately underwent treatment. Kennedy sought additional medical opinions before deciding how to proceed.

Who was right? According to Dr. Richard Liebowitz, vice president of medical affairs at New York Presbyterian Hospital and consultant to

Every Day Health

, a Web site that helps people manage their health, it was Kennedy.

Liebowitz says patients should always obtain second opinions regarding elective surgeries, or for cancer, a treatment plan.

Are two opinions sufficient?

"Sometimes yes and sometimes no," Liebowitz says. "If the doctors are independent and well-qualified and agree with each other, then yes. If they do not concur, then seek a third opinion and use them to break the deadlock."

According to Karin Rush-Monroe, a spokeswoman for

Aetna

(AET)

, "second and even third opinions are encouraged when a member or his/her physician are uncertain or uncomfortable with a diagnosis or suggested treatment."

Medicare will cover the cost of 80% of second or third opinions. Aetna has no limitation on the number of medical opinions a member or the member's doctor can solicit.

"We want members and their doctors to access the information that will help them make the best decisions about their health care," Rush-Monroe says.

Although the average person will not be able to have the access to the numbers of experts that Kennedy had, Liebowitz says, "having many opinions does not necessarily lead to a better opinion."

Before seeking an opinion, Liebowitz suggests checking the doctor's credentials and learning whether he or she is a specialist. He mentions that academic medical centers are at the forefront of research and have access to all the latest ideas.

Aetna concurs, saying "Consumers are being asked to make more health care decisions. More and more information about outcomes and cost is now available online."

One company that provides information on specialists and the hospitals together with the costs of operations is

HealthGrades

.

Liebowitz says it's hard for patients to know the right questions to ask: "The Web can provide good advice, and bad. If you have been diagnosed with cancer or Lou Gehrig's disease there are specialist Web sites that can help you." There are

other places to find good advice

, as well.

Healthline

is another resource for patients researching a serious medical condition. The site's Healthline Learning Centers provide comprehensive medical information on more than 1000 diseases and conditions -- though, of course, any health information you find should not take the place of visiting a doctor, or obtaining a second opinion from a qualified health provider.

Liebowitz says "all opinions should be in person wherever possible, to get a full evaluation. To make it easier and faster, get your primary-care doctor to facilitate, especially if it is urgent. They will get professional courtesy when contacting another physician."

For rare or complex cases such as transplants, Aetna says "the best second opinions may not be close to home. Aetna has a specialized unit that can help members get second opinions across the country."

Aetna says it can also help members access resources, when done under a national protocol, such as clinical trials for experimental treatment of cancer and other life threatening diseases.

Both Liebowitz and Aetna emphasize that you should always take copies of your medical history, reports, tests, X-rays and opinions with you when you go for a further opinion.

Dr. Liebowitz's Key Points

Don't be concerned about offending your physician by asking for a second opinion. No competent doctor will be angry at a patient going for a second opinion. If they are, then perhaps they are not the right doctor for you.

At worst, obtaining a second opinion is a waste of time -- but the upside potential is huge. A concurring opinion can provide a lot of comfort and certainty.

Look at the rankings of hospitals and the leading doctors. Consider your ability to travel. Not everyone is a Kennedy, but you all have access to quality second opinions.

The patient decides what to do. Risk and uncertainty can help a patient to decide. There are no wrong or right opinions and the patient must make decisions based on what they are hearing.

Factors that might influence the decision could be the potential outcome, quality of life or how risk-averse the patient is.

Conclusion

Ultimately, according to the surgeons at Duke University, Kennedy's operation was successful; and follow-up checks confirmed that my melanoma was successfully removed.

Although we took differing paths, we both made decisions about our treatment based on the information provided.

In Kennedy's case, in what some refer to as a radical and extremely risky operation, it was his decision, not the surgeons, to go ahead.

In similar circumstances, it will be you who is empowered to make the decisions. Do that armed with the best information that you can gather, including second opinions.

Gavin Magor joined TheStreet.com Ratings in 2008, and is the senior analyst responsible for assigning financial strength ratings to health insurers and supporting other health care-related consumer products, including Medicare supplement insurance, long-term care insurance and elder care information. He conducts industry analysis in these areas. He has more than 20 years' international experience in credit risk management, commercial lending and analysis, working in the U.K., Sweden, Mexico, Brazil and the U.S. He holds a master's degree in business administration from The Open University in the U.K.