How to get a good second opinion

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How to get a good second opinion

The General Medical Council, which regulates doctors, states that all doctors must ‘respect the patient’s right to seek a second opinion’.

The Department of Health accepts that if a doctor thinks that it is in the best interest of the patient to refer for a second opinion, they should do so.   Although you do not have a legal right to a second opinion, good practice should make this available when requested. (The formal right to a second opinion in some circumstances is currently under government review. [Martha’s Rule: September 2023] )

Why seek a second opinion?

Sometimes, for a variety of reasons, you may feel that you have lost confidence in your own doctor and that you have no faith in the advice that you are being given. This may apply to your GP or to a hospital doctor to whom you have been referred. In these circumstances it may be wise to seek a second opinion.

Also, importantly, there are pivotal moments in your medical care when, even although you communicate well with your doctor and have confidence in their professional ability, the importance of a decision is such that you would like another expert to give you an alternative view. There are times when a crucial decision is needed, for example, about what treatment is the best to do next. It is very reasonable, and supported by the administration of the NHS, that you seek the view of another doctor… two heads may be better than one. Ideally you would like the two doctors to discuss your case together.

How do you find a good second opinion?

How should you broach this with your current doctor?

Alternatively, you could say “Doctor, that may make sense for most people, but it doesn’t sound quite right for me. I would like the opportunity of taking a second opinion”.
Any good doctor worth their salt will quickly accept that if a patient wishes to have a second opinion, then it is pointless to object. The good doctor will have the confidence to facilitate a second opinion, either by suggesting an independent colleague with the appropriate training or cooperating with alacrity in facilitating a second opinion of the patient’s choice.

Since doctors nowadays work in teams and discuss cases regularly in order to pool knowledge and experience, it is likely that you, as the patient, will feel that an opinion from another team or hospital is likely to be more objective.
In order for you to get the best out of a second opinion the new doctor will need as much information as possible about your condition so far. Ideally, you will need a referral letter from the original doctor (failing that, from your GP) together with results of any tests which have been carried out. If x-rays and/or scans have been done, then the second doctor is likely to want to see the films themselves and to discuss these with a radiologist in whom they have confidence. In some cases, the second doctor will want to review the pathology from any biopsy or operation you have had. This is usually (and regularly) arranged between pathology departments at the request of your second doctor.
So, before you go for the second opinion consultation make sure that you have a referral letter and all possible relevant information. Your GP can help here if it is another specialist you want to consult. If there is material to be reviewed don’t expect an answer at the first meeting. The second opinion may need time to review and consider your case.

After taking a second opinion there are two likely outcomes. You may find that the second doctor confirms the diagnosis you have been given and confirms that the approach that has been taken is what he or she would plan to do themselves. If the opinion of the first doctor is confirmed, then you can go back to him or her and say so and continue under their care. Your doctor will be pleased that a colleague has agreed and will want to prove the wisdom of your decision to return to their care by ensuring continued good management.

If, on the other hand, the second doctor is of a different opinion and proposes an alternative approach then you have a choice to make. You can ask the second doctor whether you may change to their care and write to the first doctor explaining why you are changing your medical advisor. If neither of these opinions gains your confidence you could try a third opinion. Overall, this is to be avoided, but would be possible if essential, and no more than three!

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