Getting a Second Opinion

ByMichael R. Wasserman, MD, California Association of Long Term Care Medicine

Reviewed/Revised Apr 2023

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Despite many similarities in training, doctors may vary in their opinions about how to diagnose or treat certain disorders. Such differences can occur among the best of doctors. Differences often occur because the evidence for the best approach is not clear. For example, opinions can differ about whether or when to measure prostate-specific antigen (PSA) to check for prostate cancer in men who have no symptoms. Differences in recommendations may also be based on how a doctor interprets scientific information about a test or treatment and weighs its potential benefits and risks for an individual person, how willing a doctor is to use the latest tests and treatments, and how available these tests and treatments are in the community.

For these reasons, getting a second opinion from a different doctor can give a person additional insight and more information about what to do. If the second opinion is the same, it can reassure the person and reduce anxiety. If it differs, options can be weighed, and the result is a more informed choice about what to do. Also, a person can get a third opinion, particularly if the second opinion is different from the first.

How to Get a Second Opinion

People should check with their health insurance provider to make sure the cost of a second opinion is covered. They should also ask about and follow any special procedures for getting a second opinion.
People can ask their doctor to recommend another doctor or specialist. Most doctors welcome another opinion. However, the second doctor should not be a close associate of the first because they may share the same perspective. If people do not feel comfortable asking their doctor, they may be able to ask another doctor they trust. If not, university teaching hospitals, specialty medical societies (such as the American College of Surgeons), or insurance providers can often provide names of doctors. Although some people may not be comfortable asking their doctor about a second opinion, honestly and politely talking about why a second opinion may be helpful and asking for the most appropriate referral may improve communication and lead to better decisions.
People should have their medical records sent to the second doctor before the visit. That doctor then has time to look at the records, preventing unnecessary repetition of diagnostic tests. Because of the Health Insurance Portability and Accountability Act (HIPAA), people are required to give written permission to their original doctor to forward any records or test results.
People should write down questions and concerns about their disorder and bring the list to discuss with the second doctor.
People should generally go to the doctor in person to get the second opinion, as opposed to relying on telemedicine. For a second opinion to be meaningful, the doctor should thoroughly review the medical records and do all relevant parts of a physical examination. Often the physician may want to see some of the imaging studies (not just the reports) or pathology samples, and copies should be obtained in advance.

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