Second opinions

February 1, 2005 4:12 PM

When I go for a second opinion, should I tell the person I'm asking that it's a second opinion?

I'm specifically asking about doctors, but this could also apply to mechanics, or really any expert. Would a person who's asked for a *second* opinion be more likely to try harder to be objective/thorough and take a fresh look, or more likely to go along with the first expert? How can I get the best second opinion? (Note: this is not a second opinion about anything life-threatening, like whether or not I have cancer.)
posted by acridrabbit to shopping (11 comments total)

Read today's WSJ article on the subject?
posted by ParisParamus at 4:22 PM on February 1, 2005

As a general rule, I'd say "No", just because you ideally want an unvarnished opinion. (Plus, anyone who'd try harder or be more honest just because they're a "second opinion" is suspect, to start with.)

Even if I do feel inclined to share that I've already talked to somebody else--which isn't necessarily a huge deal--I'm usually careful of telling the second person what the _first_ person thought, unless it was really relevant. That makes it really hard to get an "objective" opinion, if that's what you're looking for.

On the other hand, outside the medical realm, if you're really just doing something like shopping around on price, it's less of an issue. Tell them what you think it is, tell them you got an estimate from someone else (but _not_ how much), and see what they say. (I'm talking about mechanics here, not doctors.)
posted by LairBob at 4:24 PM on February 1, 2005

Yes, I just bought a furnace - and I felt it was important for the furnace salesman to know that I was comparing notes between installers....

I got 3 opinions and I ended up saving $1000 this way.
posted by mildred-pitt at 4:48 PM on February 1, 2005

Paris - no, got a link?
posted by acridrabbit at 4:54 PM on February 1, 2005

I agree in large part with LairBob, but with a caveat pertaining to the medical realm: being truthful with the provider helps to build the relationship. Furthermore, if the provider has all the results of laboratory testing, radiology films/reports, etc. they have a better set of data to make their diagnosis upon than pure conjecture or impression.

For your second opinion, I think one of the very important prerequisites is how did you find this other generalist or specialist? Does anyone you know have experience with him or her?

IANAD, but work with a board-certified internist who I have alot of respect for. Our patients depend upon us and we don't take their trust for granted. If someone wishes to have a second opinion, we encourage them to do so and will provide any referrals they might need. If the providers ego is too great to recognize a person's desire for certainty or to quell any doubts, the provider has and will continue to do the patient a disservice.

/end tangent
posted by sillygit at 6:08 PM on February 1, 2005

If I was seeing you, it would definitely be germane to know that you were there for a second opinion. Things like your sense of the previous doctor's demeanor, listening skills, empathy, explanations, tolerance for your questions, etc. often have a lot to do with a persons decision. For your sake, who cares if the doctor pays more attention? Isn't that the point? I always tell my folks to take one or the other with them to their appointments for the same reason.
posted by docpops at 8:11 PM on February 1, 2005

I'd like to know. Most of what I do in the office is taking a "history," and the history is centered around the "chief complaint." Neurologic diagnoses are not easy to arrive at, and having to spend thirty to 45 minutes covering ground that's already been covered is far more difficult than something like:

"I had some leg pain. My doc says he thinks I have meralgia paresthetica and a left S1 radiculopathy."

"So you have burning pain on the side of your thigh most of the time, and a sharp shooting pain, maybe intermittent, radiating from your lower back down to the sole of your left foot?"

"Yep."

"How long?"

"4 weeks."

"Great. Let's sit you up on the table and see if the exam findings gibe with those diagnoses."

Not that it would always be that simple, but honestly otherwise it's like:

"Why are you here?"

"My leg hurts."

"For how long?"

"4 weeks."

"What kind of pain?"

"Well, it's a burning pain always, and sometimes a shooting pain."

"Where do you feel the pain?"

"At home and at work."

"No, I meant where in the body do you feel the pain?"

"Oh. On the side of my thigh, and the sole of the foot."

"Which is which?"

"Huh?"

"Which is the burning pain, and which is the shooting pain?"

Etc.

If I wanted to pull teeth, I'd've gone into dentistry.
posted by ikkyu2 at 8:36 PM on February 1, 2005

Yeah, I kind of missed the explicit focus on doctors that you mentioned, in my first response--I thought you were more just asking about second opinions in general, with doctors as kind of a case in point.

I'd definitely say that going to another doctor for a second opinion is a special case. Unless I really didn't _trust_ the first doctor and their opinion, and wanted someone to really take a look with no pre-assumptions, I'd think I'd definitely be more open with the second doctor. I've certainly never hesitated to tell a new physician everything I could think of that I had talked about with a previous one, and this is basically a similar situation. (On preview, to ikkyu2's point, you can save both of you a lot of time and aggravation.)

With a cranky car, or a bad boiler, of course...totally different.
posted by LairBob at 8:41 PM on February 1, 2005

Note especially you don't want to have to re-do any x-rays or other radiological exams, for obvious reasons. And some other kinds of tests are simply unpleasant, or worse.

A second opinion can be desired for more than one reason. Both diagnosis as well as treatment might be what you wish the opinion on.
posted by Goofyy at 12:15 AM on February 2, 2005

Yes, I just bought a furnace - and I felt it was important for the furnace salesman to know that I was comparing notes between installers....


I went through this last summer, and I told them I was shopping around when they asked me "When can we expect to hear from you with a decision?" They all had differing approaches to solving the same basic problem, which was how to get rid of condensation wrung out of the air by the air conditioner and excess water used by the humidifier in winter. One wanted to run it through a fairly long PVC pipe and route it to a drain in a bathroom. One wanted to use a pump to send it to my laundry tub. Another told me that the building code forbade discharging water into a laundry tub in that manner. One wanted to discharge the water outside the house near my foundation. I researched the building code myself (.pdf on a web site) and went with the guy who wanted to route it to my laundry tub. I think when different solutions to the same basic problem must be considered, two or even three opinions can be good.
posted by fixedgear at 2:32 AM on February 2, 2005

By the way, if it's not obvious, I think second opinions are a great idea. I give them, and I am happy to refer someone to get one. I don't pretend to be the world's greatest doctor in any area.

Also, when I give an opinion, it's my opinion. I am acutely aware that when I make a diagnosis or recommend a treatment, that I am responsible - legally and morally - for the consequences. I'm not going to alter what I say to salve the other doc's ego or for any other reason.

Sometimes people want a second opinion for a particular reason or concern. For instance, half the patients I see with migraine headaches are secretly convinced they have a brain tumor. For some reason, a lot of people worry about this but they don't bring it up with the doc. I've learned to say, "First of all.. you don't have a brain tumor," when I start my headache discussions (Unless they do, and that's generally a sucky discussion). But if there's another hidden agenda, I might not be able to recognize it if the patient doesn't tell me what it is! And certainly if someone's coming to me because of a particular concern I want to address that concern.
posted by ikkyu2 at 9:59 AM on February 2, 2005