How to choose a doctor when you need a second opinion

If you’ve been diagnosed with a serious, complex, or rare condition or if your doctor has recommended surgery, a second opinion can help you make sure you avoid being misdiagnosed and receive the most appropriate treatment for the condition you face. But what factors you should consider when choosing which doctor to consult for your second opinion?

Finding a qualified specialist

The first step towards getting a second opinion is to find a physician who has experience and success treating your condition. There are several different sources you can use to find a specialist for your consultation, including:

• Your primary care physician or the physician who diagnosed your condition: Most physicians will understand your desire to get a second opinion and may be able to recommend a physician they feel has the needed experience to evaluate your current diagnosis and treatment plan. However, their choice may be limited to a specialist within their local health system.
• Your insurance company or local hospital’s list of providers: Some of these lists include quality ratings for physicians, but it’s important to find out what information these ratings are based on. What you want are ratings based on objective outcomes data such as complication, mortality, and success rates rather than ratings based on solely patient satisfaction surveys. Also, insurance network lists tend to be set up in a general way, for example by zip code, irrespective of whether or not the specialist has specific expertise or experience.
• A health advisor. A health advisor team with diverse research resources can connect you with carefully vetted specialists who have experience and expertise treating the condition you face.
• Online or virtual second opinion services. There are a growing number of services that offer second opinions through online or phone consultations after reviewing your medical records. As with an insurance company’s or hospital’s list of providers, it’s wise to learn which physicians will be providing your virtual second opinion and what their experience is treating your condition.

 What to consider when choosing a physician for a second opinion

 There are several factors to take into consideration when choosing which physician you want to consult:

• The specialists generally should not belong to the same medical practice or group. It’s less likely that physicians in the same practice will contradict a colleague’s diagnosis or treatment recommendation and more likely that they share the same approach to treating your condition, so seek your consultation from an unrelated physician.
• The first doctor’s recommendation may affect the second’s. Some studies have found that if the first physician recommended a more interventionist treatment, such as surgery, the second was more likely to also recommend that treatment. It can be helpful to ask the doctor you consult for a second opinion what are all the potential treatment options and what are the pros and cons of each.
• If there are non-surgical treatment options, get an opinion from a doctor who does not perform surgery. If your original physician recommends surgery, but there are effective non-surgical treatments for your condition, such as back or knee pain, seek the input of a physician who offers non-surgical treatments like physical therapy, pain management, and/or lifestyle changes such as weight loss and exercise.
• The physician should be board certified and have training and experience treating the specific condition you’ve been diagnosed with. In addition to board certification, ask the physician you’re considering if he or she is fellowship trained, how often he or she treats your condition, and what his or her complication and mortality rates are. A fellowship trained spine surgeon, for example, is very different than a general orthopedist. If you’ll be undergoing surgery, it’s also valuable to find out what the infection rate and readmission rate is for the hospital where your procedure will be performed.