Second opinions count

"Let's do more tests."

So this doctor told me the other day that I'm dying. I said, "I'd like a second opinion."

"Okay," he said. "You're ugly, too."

That's an old joke, but I'm an old guy.

I've gotten second opinions on lots of things over the years. I've even gotten third opinions. Here's some advice from Johns Hopkins Medicine:

When faced with a serious medical condition like prostate cancer, many men seek a second opinion to confirm their diagnosis or clarify treatment options. Yet others dread getting a second opinion for fear of offending their doctor. But that's rarely the case: Doctors are accustomed to having their patients consult another doctor to get a second point of view, and some doctors may recommend it.

What's more, you may not have a choice in the matter. Your insurance company may require a second opinion for certain therapies and procedures, particularly if your treatment is expensive. Even so, do check with your insurance company before getting a second opinion to make sure the visit is covered.

When doctors disagree: What studies show

Medical research strongly supports the value of second opinions. For example, after reviewing slides of tissue obtained from breast cancer patients, pathologists at Northwestern University had major disagreements with the initial diagnoses -- almost all made at community hospitals -- that altered the surgical procedure in 8 percent of patients. 

The second opinion also changed the prognosis in 40 percent of cases. At the request of patients, Wills Eye Hospital in Philadelphia offered second opinions for 100 patients undergoing eye surgery. The reviewers disagreed with the initial diagnoses or management in 15 percent of cases, a finding that further underscores the importance of second opinions for surgeries, in particular.

Finding a second doctor

It's easiest to ask your primary care physician for a referral. Or, if you prefer, call the local medical society or a nearby medical center or medical school for the names of specialists. You can check credentials in the Official American Board of Medical Specialists (ABMS) Directory of Board Certified Medical Specialists, available at most libraries or online at www.abms.org.

Referrals from friends, family or support networks may also be worthwhile. But always check credentials. Some departments at Johns Hopkins provide second opinions remotely for patients unable to travel to the Baltimore area. For details, visit www.hopkins medicine.org/second_opinion or call 1-855-695-4872.

Getting medical records

Your physician should send your relevant medical records, including x-rays and blood tests. Because of strict privacy laws on personal medical records, you'll have to sign a release. The process can get tricky, as test results and other medical information may come from unaffiliated offices. Poor management of medical records is unfortunately a common problem for patients, hospitals and doctors.