Embrace the Second Opinion

She flew interstate for the consultation. I’m assuming she found out about me on the internet and felt she agreed with my practice philosophy and style.

The reason? A second opinion.

To be clear, she really respects her current rheumatologist but she just wanted clarification on a number of issues.

I have no problem with this. It’s a reasonably common occurrence in my practice and in turn, I’ve had patients who have looked for another opinion.

What’s sparked this post is her worry about her current rheumatologist finding out. I often send a copy of my correspondence to the prior rheumatologist out of courtesy and because I expect they would be interested, but I always ask the patient’s permission to do so. She preferred that I not.

I thought I’d make it clear that I think second opinions are a good thing. Something we probably should embrace a bit more.

Some reasons include:

• Another opinion can confirm and clarify, improving the confidence in a management plan. Rather than procrastination, progress may result.
• When there is doubt due to an unclear diagnosis, fresh eyes might come up with different possible solutions.
• In rheumatology, the “art” of medicine is important. Most things do not have high level randomised controlled evidence so solutions may result from a blend of experience and bias. Sometimes, an alternative experience +/- bias is needed.
• Sometimes, patient and doctor just don’t gel. A good relationship does make a difference so it might be time to test out another.

Every year, I do suggest to a few patients that they should consider getting a 2nd opinion and a couple do. It’s likely a few more do and I’ve just been kept out of the loop.

I don’t take offence. I actually think it can be very helpful.

Do you embrace the second opinion? What’s your experience?