When to Get a Second Opinion

Written by: Alan Edwards

Most people think that if they are told they have a serious illness they need to get a second opinion. And this is one of the few times that conventional wisdom is correct. Before you make life-altering changes or agree to risky therapies or even surgery, a second opinion is in order.

As a former health executive, I was frequently asked: “What do you do if the second doctor does not agree with the first.” My advice was and is: get a third opinion. If your third opinion disagrees with the first two, in other words you now have three opinions, go the finest teaching hospital you can find and find a doctor on staff who has great credentials and get a fourth opinion.  Or, find yourself a damned good primary care doctor and get his advice. Generally they know a little about everything and usually enough to help you decide on a course of action.

But, if you do not have a life threatening situation but do have a high deductible you might want to get a second opinion before undergoing expensive diagnostic testing. Your portion of some testing and treatments too, could be very high if your deductible is not met.

If your doctor tries to have you get testing or treatments at a facility that he/she has an ownership interest in you should get a second opinion about the need for that test or treatment. However, many doctors are now employed by hospitals that own Out Patient Surgery Centers, Physical Therapy Centers, diagnostic labs, and x-ray centers that include imaging and nuclear medicine. While these doctors do not have a financial interest in where you go for testing and treatment, their employers do. Though, it is illegal to reward a doctor for sending patients anywhere at salary raise time it may be an unspoken statistic that influences a physician’s income. While it may be uncomfortable, it is reasonable to ask if the doctor or his/her employer has an interest in where you go for testing and treatment. If you are a cash patient and determine that the test or treatment is needed call around and comparison shop. Ask the diagnostic or treatment center what your entire fee will be and compare it to others. If they are high, tell them so and ask for a discount that matches the middle range. If they refuse, tell your doctor you want a referral to some place and the reason why you are asking for it.

Make sure you get the quality of care you deserve at a fair price.


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When to Get a Second Opinion

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