E-360 Edition 15: Seeking another opinion

Home > E-360 Edition 15: Seeking another opinion

When we embark on a major purchase, we often do the research and shop around to find the best deal that suits us. However, many people do not take this approach when seeking a health professional. Sometimes this may be related to location, availability or simply uncertainty of who to see, but a second opinion is your right as a patient.

Obviously an emergency situation is not the time to shop around, but assuming you have at least some time and the ability to get to another doctor, there are many situations where it could be worthwhile.

When to get a second opinion

Epilepsy can sometimes require complex or life-changing management, either in health, lifestyle or financial terms or all of the above.  Given that it is an unpredictable condition with many different types of seizures, and symptoms the doctor often doesn’t see, occasional misdiagnosis can occur. A second opinion can sometimes be invaluable to provide clarity, either confirming the original diagnosis or treatment, or offering a different approach.

So if you are unsure about a doctor’s medical advice or diagnosis, or if you just want to confirm that the planned treatment is your best option you may ask for a second opinion.

It may feel awkward to ask for a second opinion, but it is a relatively common request. In some cases, you can make an appointment with a different doctor, specialist or healthcare professional without talking with the first doctor. However, it is probably best to ask your doctor for a referral, especially if they have your medical history, test results and records. These can make it easier for the second doctor to make a diagnosis and recommend treatment and may also save you from having to retake medical tests.

People may choose to see another doctor if:

  1. The doctor seems unclear or uncertain

It is fair to say that epilepsy isn’t always black and white – it can be a complex condition with over 40 different seizure types and many different syndromes. There are many neurologists who don’t specialise in epilepsy and someone presenting with several different symptoms that may or may not be related, might not be able to get a clear diagnosis straight away.

If the seizures are severe or the situation is serious, then that specialist may recommend a colleague or a different neurologist. Sometimes it might just be a case of wait and see.

When there is uncertainty about a specific diagnosis or the best course of treatment, a second opinion is often a good option.

  1. There isn’t good communication

Many people who seek a second opinion do so because they are unhappy with the information they’ve been given about their condition. Or they may also be unhappy with the way their diagnosis and treatment recommendations were communicated to them; they are seeking a clearer explanation or a doctor they feel a better rapport with.

  1. There may be more than one option

Although epilepsy is largely treated with medication, there are other treatment options available, and you may benefit from knowing what others would recommend and why. There are epilepsy medications that are known to be more effective with specific types of epilepsy, just as there are some types of epilepsy that may be suitable for surgical treatment. Seeing a doctor that can explain the options to you, including lifestyle changes, can really help.

  1. It just doesn’t seem right

No one knows your body like you do. You may have niggling doubts or concerns, and don’t feel completely confident about your doctor’s diagnosis. Or maybe the treatment your original doctor recommended isn’t working as it should, suggesting either the diagnosis or treatment needs reviewing.

  1. If you just want to make sure

Even if what your doctor says makes sense, getting a second opinion can provide clarity, reassurance and peace of mind.

How to go about it

In theory, doctors should welcome or even encourage a second opinion. In reality, there may be some doctors who are uncomfortable or feel challenged when asked about a second opinion, some may even feel it undermines their authority. If a doctor is reluctant or dismissive about you getting a second opinion, that may be all the more reason to get one.

  1. Let your current treating doctor know.It will help preserve your longer-term relationship with them and make sure the new one you are seeing can get all the information they need.
  2. Be clear in your mind about what the reason for the second opinion is.Are you seeking an opinion, or wanting ongoing care from the new provider? List what you hope to gain from the second opinion, whether it’s simply better clarity, different treatment options or even lower costs. Sometimes the second doctor won’t ask, but it’s good to have something prepared to explain your visit. Are you prepared to re-think the current diagnosis or treatment plan if this is recommended?
  3. Be open with the new doctor that you are seeing.This will focus their attention on the part of your care that you’re concerned about. If second opinions are mostly being obtained for reasons of communication style and doctor-patient relationship, it would be plausible to assume that you will be more satisfied and do better generally with a doctor you can relate to well.
  4. Get your records together, including your history, test results, investigations and other images, and the proposed management plan if there is one. You can ask your first doctor for any paperwork you may not have, otherwise the second doctor can request it.
  5. Ask about additional costs, or be aware of any further costs involved. Second opinions may lead to spending more time and effort, especially if you have to travel. Be aware that you may feel more obliged to follow advice you’ve gone to so much effort to obtain. This is also one of the reasons that you should have clear in your own mind what the point of the consultation is. Take your time to consider the second opinion as carefully as you did the first
  6. Take a family member or friend along when you see the second doctor, especially if they are familiar with your seizures and history. They often can fill in any gaps of information.
  7. Don’t consider the internet to be the final word on second opinions. The smartest people in medicine are not the ones writing on blogs and forums or selling their unique products online. Stick to reliable, trustworthy sites from big institutions, and use this information to get a “background briefing” rather than to make a diagnosis yourself.

How do you find someone else?

You could ask friends, family and other people in your social networks, search for relevant specialists online or check out patient support group forums. If you live in a rural region or have a rare condition, you may not actually have a lot of choice.

Ask your GP – if they referred you to the first specialist, you could ask for a referral to a second.

You could also ask your health insurance fund – some, including HCF, HIF and CBHS, offer a second opinion service called Best Doctors, an international coalition of thousands of medical specialists. The doctors are sent medical files and treatment plans to review, though don’t actually meet the patient. Some life insurance companies offer it too.

Should you mention it’s a second opinion?

Many people worry about offending their first doctor by getting a second opinion – and then if they should tell the second doctor what the first doctor said, which may influence their response.

These concerns aside, in most cases it’s best to be fully transparent. If you expect your doctor to be clear then it’s a good idea to do the same yourself.

How do you choose which opinion is right?

After seeking a second opinion and when you have all the information you need, you may feel more confident to make a decision about your treatment.

When the second opinion differs from the first, it may not mean that it is a more accurate diagnosis or opinion, just different. Sometimes there is no right or wrong, just different management approaches. Ask for the reasoning behind their advice – you want to know why. However, if it is a more accurate diagnosis or preferable management plan, then this is a positive step in moving toward the right management of your seizures.

Unless your first doctor is completely in the dark, it is more likely a second opinion won’t be radically different from the first, though there may be refinements. As for treatment options, go with the one that makes the most sense, involves the least risk and addresses the concerns that are most important to you. This may mean going back to the first doctor and asking them to justify their advice.

And if there are major differences and you’ve been left more confused than ever, you may need a third opinion!

Your involvement

An important part of being involved in managing your epilepsy is learning how to make decisions and how to talk with your doctor. To make an informed decision about your health, be honest with your doctor and healthcare team and remember you have the right to ask about all your options and seek a second opinion if you want to.

It may be that you want to get a second opinion because you do not understand your doctor’s diagnosis or recommendations. It is fine to ask your doctor more questions and ask for a second opinion so you can fully understand your health issue and treatment options.

Just remember:

  • You have the right to ask for a second opinion if you are unsure or unhappy about your doctor’s suggested medical treatment or diagnosis.
  • Ask your doctor to give you a referral to another doctor or specialist.
  • Ask your doctor to send the other doctor any test results or medical history.
  • Chose the doctor and treatment plan that is most suited to your needs.

Everyone who is seeking or receiving care in the Australian health system has certain rights regarding the nature of that care. These are described in the Australian Charter of Healthcare Rights. The rights included in the Charter relate to access, safety, respect, communication, participation, privacy and comment.

For more:

Australian Charter of Health Rights: https://www.safetyandquality.gov.au/wp-content/uploads/2009/01/A-guide-for-patients-consumers-carers-and-families-v3.pdf

Best Doctors https://bestdoctors.com/australia/

HIF second opinion https://www.hif.com.au/blog/hif-news/have-you-heard-about-hif-second-opinion