What to Ask in a Second Opinion

If you received a diagnosis from a neurosurgeon, you may have many questions about your specific condition and the proposed treatment plan, such as: "Are there other options?", "How much experience does my doctor have in treating this condition?", and "What does it all mean?"

Being faced with making critical decisions about your health requires gathering information so you can make the most informed decision for your situation. This is where getting a second opinion is vital. Whether you are comfortable with your doctor's assessment or feel you need more information, getting a second opinion is now becoming standard practice. It is often recommended by doctors and insurance companies for rare or serious illnesses or when major surgical intervention is contemplated.

In addition, because medicine is not an exact science, sometimes diagnoses or treatment offerings may differ from doctor to doctor due to diverse levels of knowledge and experience. Since receiving an accurate diagnosis is crucial for an effective treatment, let's learn more about how to approach a second opinion and what you should ask to get the most out of your second opinion consultation.

You recognize the value of getting a second opinion and believe that it is a sound choice for you and you would like to proceed. But where do you go from here? You may have many questions you want to ask and are unsure about where to go or what your next steps should be.

• Will my doctor be offended if I seek a second opinion?
• What questions should I ask a second doctor?
• Will I be able to get a second opinion quickly?

These questions are all valid and understandable. Receiving a serious health diagnosis can be stressful. Seeking a second opinion may seem like going through the process all over again, adding to your stress.

Below, we will present some simple tips regarding important things to know, including how getting a second opinion works, which will help you navigate the process more smoothly.

Because second opinions have become commonplace, they have also become big business. Being an advocate for yourself involves doing your research. This may sound like a tedious ordeal, but it boils down to understanding some essential information about the doctor from whom you are seeking a second opinion.

In the following section, we will share specific questions to ask your first-opinion and second-opinion doctor. First, lets discuss some aspects of your research.

• Experience – How many patients have they successfully treated or have done surgery for with your condition?
• Research – How familiar is the doctor with your particular condition? Have they done research on your disease that has been published?
• Connections – Does the doctor have a network of colleagues familiar with your condition that he or she can access?
• Reputation – Does the doctor have a professional reputation of respect among those familiar with your condition? The reputation of the specific doctor is more important than the reputation of the hospital he or she works for.

You may be worried that requesting a second opinion will offend your current doctor and cause conflict in the relationship. This is a common belief, however, most doctors will respect this request and some will even offer assistance. But what should you say to your doctor? Here are some suggestions:

• I am considering getting a second opinion. Do you think that is a good idea and would you be able to help me?
• Because this is such a crucial decision, I'm going to include getting a second opinion as part of my decision-making process.
• I really value the relationship we have and your expertise. However, for my peace of mind, I am going to get a second opinion to make sure I've covered all my bases.

Once you have decided on a second doctor, prepare for your appointment in advance by writing down the questions you want to ask and gathering pertinent information and documentation related to your medical history.

Below is the information you will want to provide to the second doctor:

• Diagnostic or imaging results
• List of medications, dosages, and whether you felt any improvement in your condition
• Records of conservative or alternative management plans and whether you felt an improvement
• Relevant surgery or biopsy reports
• Relevant hospital discharge reports
• Current doctor's treatment plan

Your questions should focus on helping you get a better understanding of the physician's background which qualifies them to diagnose and treat your specific condition, as well as how the new doctor's diagnosis and surgical experience is the same or differs from your current doctor's diagnosis/experience and why. Here are some examples of questions:

• How did you arrive at your treatment recommendations for me?
• How did you interpret my test results?
• What research studies did you consult in formulating your recommendations?
• How many people have you successfully medically or surgically treated with my condition?
• Have you authored any research on my disease?
• How have other patients with my condition responded with your treatment plan?
• How are your surgical risks and results compared to national statistics?
• Does your hospital own state of the art technology for minimizing the risks and maximizing favorable outcome for my surgery?

If the opinions of your second doctor agree with those of the first, you can decide if you want to proceed with treatment and which doctor you would like to treat you. If assessments are different, the additional knowledge from the second opinion may help you make a more informed decision. If the opinions are vastly different and conflicting, you may want to investigate a third opinion or ask both doctors more about how they have come to their conclusions.

Regarding your neurosurgical procedure, the expertise of the surgeon is more important than the reputation of the hospital. Your primary care doctor can find out about the reputation of the best surgeon in your area for your specific condition via his network of physicians. This “word-of-mouth” reputation among colleagues is of utmost importance as compared to other forms of marketing reputation.

Finding the best care is paramount when diagnosed with a serious health condition. Including a second opinion as an essential part of the decision-making process can help to provide peace of mind and improve your health outcomes.

• American Association of Neurological Surgeons