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Should I seek a second opinion?

Should I seek a second opinion?

Trust what the doctor says, we are told, so when is it okay to get a second, third or even fourth opinion? Professor Kerryn Phelps explains.

The question of second opinions comes up all the time in medical practice.

The type you may be most familiar with are the referrals to specialists in a particular area of expertise, such as a dermatologist or a cardiologist when you have a specific health issue.

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Usually this is because the GP you are seeing knows that they need the opinion of an expert who is focused on a particular disease or body part.

A lot of my patients talk to me about second opinions from specialists. Quite often the conversation begins tentatively.

It is usually along the lines of, “I have been seeing my specialist for years, but I don’t feel I am improving at all. I really want to get another opinion, but could I do that without him knowing because I would not want to upset him. He has been so good to me”.

Sometimes, I see a patient for the first time because they have not been happy with the way their health has been managed so far, in which case I am the one being asked for a second opinion. In some cases, it turns out to be a third, fourth or even fifth opinion.

PROS AND CONS

There are advantages and disadvantages to seeking extra opinions. I am the first person to encourage people to be active participants in their healthcare decisions and seeking opinions is one way of gathering the information you need.

Medical diagnosis and healthcare is not always an exact science and sometimes medical conditions can be very complicated. So, if you are in a situation where you are not making progress, it makes sense to get a fresh perspective.

It is also hugely important to choose doctors in whom you have complete confidence. People are often reluctant to hurt “their” doctor’s feelings and I understand this. Many doctor-patient relationships are very close and personal, and it can feel a bit disloyal if you go looking elsewhere.

However, getting your health on track is far more important than the possibility of hurting someone’s professional pride. This can be handled sensitively, by the doctor providing the second opinion communicating back to your usual GP or specialist with your permission.

Be aware, though, that your GP is not obliged to provide a referral for a second opinion if they do not believe it is in your best interests, but you need a referral in order to get a Medicare rebate for the specialist’s consultation.

HOW TO SEEK A SECOND OPINION

The health system in Australia makes it relatively easy to seek second opinions. If you feel you want a different GP’s perspective, you just need to make an appointment, take along as many results of blood tests, scans and specialist reports as you can get hold of and go to another GP. The downside here is that some tests may be repeated unnecessarily and there is a loss of continuity of care.

In a group general practice, we are accustomed to the possibility of patients seeing various practitioners in the group from time to time and that does often bring a new perspective with all of the records in one location.

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Yet I have come across doctors who have felt threatened or annoyed by patients seeking other opinions. Really, that’s just too bad. Your health is the priority.

If you want a second opinion from a specialist, you can discuss that with your GP.

Your doctor will need to be satisfied professionally and ethically that the second opinion is in your best interests. A referral by a GP has legal and ethical requirements on the doctor – it is not automatically provided on a patient’s request.

Read more of this story in the July issue of The Australian Women’s Weekly.

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