To Second Opinion or Not, what is the etiquitte?

October 23, 2011 2:57 PM

What is the etiquette for getting a second opinion? I like my primary care physician, but am feeling on one issue that she may not be doing all that she can. But it could also be me. . .

I've been with my current doctor for probably 10 years now. She's helped me through a variety of issues. However, I've had a slow accumulation of symptoms, over the past few years, and initially she seemed to be very concerned, but as they've lingered and tests have come back with no answers, I feel a bit like she sees me as "that patient" that comes in and complains all the time. She's never said such, so it really might be my own frustration at a lack of diagnosis, but I really am beginning to feel that way.

Lately, I've felt much worse, got a whole new battery of tests, with nothing out of the ordinary. She's now referred me to a specialist for one possible cause. I won't be able to get into that doctor another month, and I'm feeling worse than I ever have, and its starting to affect parts of my life in a way it hasn't before. I'm also not convinced that the specialist's area of expertise is the cause, though I see my doctor's point in wanting to rule it out.

I've been thinking of going to see another PCP, to get another set of eyes on me and my records, as it were. However, I don't necessarily want to stop going to my doctor, especially if there really isn't an obvious answer and a new doctor doesn't do any better than my current doctor.

I'm not sure I'm willing to rule out my own frustration/impatience here and not a failing of my doctor. Other times she's been amazing when I've had problems, and in a few cases felt like she really went the extra mile, including a time when an Urgent Care doctor completely blew me off with a diagnosis of "stress" when I knew something was physically wrong. She did too, and had me feeling better in a couple hours. So I have good reason to want to stay with her. She's also really responsive, calls back right away when I have a concern, and I can usually get in to see her quickly.

At the moment though, I feel a bit lost. Is it normal to seek out assistance from another doctor? Do I just wait until I can get into the specialist she referred me to? If I see another doctor, do I coordinate care with my current doctor, or is it generally assumed that is the end of the relationship with one doctor?

posted by [insert clever name here] to health & fitness (15 answers total)

Absolutely get a second opinion. If your doctor is as great as you say she is, she won't care. No doctor is all knowing, and when it comes down to your health, you need to be in charge. Your doctor has a lot of patients. You only have one body.
posted by roomthreeseventeen at 2:59 PM on October 23, 2011

For the same reason that we don't always see how bad things get or how much weight we've gained/lost etc, your doctor has lost perspective on your situation.

You can, and should get a second opinion. I've lived with chronic health problems for about 8 years, and the best progress I've made is when I move to a new specialist/GP. They can often see things globally, instead of just in isolation.

Good luck.
posted by guster4lovers at 3:18 PM on October 23, 2011

Get a second opinion and don't feel bad about it at all, even for a second.

My mom is the sort to stay loyal to her professionals. She saw her same hairdresser for years after he started phoning it in and had several really awful haircuts as a result; she only stopped going there when he retired. She was with her same GP for 23 years until he retired and switched his practice over to a new doctor. At the get-to-know-you check up, the new doctor took all new bloodwork, took a detailed history, and paid close attention as she was seeing everything for the first time. And that's when we found out that my mom has been dealing with hypothyroid problems for at least several years. Old doctor totally missed it.

So absolutely go see a new doctor. It's good practice to switch it up every now and again, even if you're perfectly happy with the one you've got, since people overlook stuff they're familiar with.

And just a note...maybe try looking for an internist instead of a GP. I've been seeing an internist for the last two years, and he asks better questions than any of the GPs I've ever seen. (Might be a personality thing, but why not go ahead and try?) Good luck!
posted by phunniemee at 3:41 PM on October 23, 2011 [2 favorites]

I don't see the harm in it at all.

Situation A: You see a new doctor, have some new tests done. The new doctor can't find anything either. You're out a little money, but your trust in your current doctor is confirmed and renewed.

Situation B: You see a new doctor and they do find something that your old doctor didn't spot. You can start fixing your health issues.

Your doctor's feelings won't be hurt either way. You'll feel better either way. Go for it.
posted by Garm at 4:07 PM on October 23, 2011

Is it normal to seek out assistance from another doctor? Definitely! This is your health, you do not need to feel bad for getting as much help as possible in finding the cause of your problems.

Do I just wait until I can get into the specialist she referred me to? Nah, go see another doctor. Maybe you'll go to the specialist appointment too, or maybe the new doctor will have some insights or maybe even a diagnosis that would make that other appointment unnecessary.

If I see another doctor, do I coordinate care with my current doctor, or is it generally assumed that is the end of the relationship with one doctor?
Just go see another doctor. Don't worry about notifying your current doctor. If the new one has any ideas, then you can mention them to your doctor, and she'll tell you how you'll proceed regarding co-working your case or whatever. If you feel uncomfortable telling her you did this because you think she will hear it as "I didn't trust you and went behind your back," you can tell her a white lie about how your co-worker just pestered you to death to go see her AMAZING doctor or something. If the new doc doesn't have info for you, go see another one.
posted by coupdefoudre at 4:16 PM on October 23, 2011 [1 favorite]

Okay, it sounds like I should see a second doctor. One more related question. What will be the outcome of requesting records from my current doctor? A few weeks ago I *did* set up an appointment with a different doctor at a different clinic. I ultimately canceled it and decided to see my doctor again, to see where it would go (that's when she ran more tests and referred me to a specialist). That clinic wanted me to have my records forwarded over, or pick them up and bring them to my first appointment. Is it normal to get records from your doctor's office? Are they going to be, for lack of a better way of saying it, weird about it?
posted by [insert clever name here] at 5:07 PM on October 23, 2011

There is no "etiquette". You are the consumer, it's your body, your health and your money. If you have any questions or doubts that are not being addressed, you owe it to yourself to explore further. I would research and make a couple appointments. Don't go out of your way to notify her but do let her know next time you see her. Be polite, direct, and confident in your decision. If she is a professional, she will be fine with it!
posted by thinkpiece at 5:08 PM on October 23, 2011 [2 favorites]

Those records belong to YOU. I have much experience here. You are entitled to copies of all your records in a timely fashion so that you can share them with your new/alternate doctor. It's not weird or unusual. They belong to you!
posted by thinkpiece at 5:09 PM on October 23, 2011

For sure I would get a second opinion. Doctors are still employed by you the patient. If you don't feel you're getting the service you want, find another one. Second opinions are a normal part of the medical world. You may go to another doctor and find out that your current doctor isn't right for you anymore. Or you may go to another doctor and find out how good your current doctor really is. Either way you have nothing to lose.
posted by ljs30 at 5:15 PM on October 23, 2011

Ask for the records so that you can give them to the specialist. If they offer to fax them to the specialist, tell them that you'd like to bring them yourself. Don't argue or apologize, just be firm and repeat your request.

They might have you fill out or sign an authorization if you're having them mailed or faxed, just to be sure it's you requesting them and you're okay with where they're going.

I've found it easier to get records by fax than any other way.

Give your records to the new doctor ahead of time; I'm under the impression that doctors review the records before talking to you if they're available.
posted by the young rope-rider at 6:57 PM on October 23, 2011

The specialist is in the same group with the same records system, so they already have that. I am, however, going to just request to pick them up in person. It occurs to me it wouldn't be a bad idea to look over, and make sure that I've given my doctor all the details. I think I have, but I deal with my symptoms every day. Maybe there is something I am unwittingly forgetting to tell her. And then I can take them to another doctor or any place I need to.
posted by [insert clever name here] at 7:51 PM on October 23, 2011

Edit: Oh this just got easier - the medical group my doctor is part of has a form online that I can print and mail or fax and have my medical records sent to my home.
posted by [insert clever name here] at 7:54 PM on October 23, 2011

Absolutely get a second opinion.

Not only that, get a third or a fourth if you think it's necessary.

Your health is #1.
posted by crawltopslow at 12:22 AM on October 24, 2011

Doctor X, I'm really frustrated that I've been feeling crummy for quite some time, and am not feeling better. I'd like to pursue different approaches. I'm not sure what those might be. can you think of any traditional or alternative health care providers who might be worth seeing? No doctor should give you a hard time about a 2nd opinion, but maybe your doctor doesn't see how bad it is for you, and needs a bit of a nudge. Your doctor can usually get you in to see other docs faster. And, your health insurance may require a referral. By discussing it, you may get some benefit, and also let your doc know that you aren't necessarily unhappy with his care, but need another opinion.
posted by theora55 at 7:22 AM on October 24, 2011

As you've probably figured out by now, getting the medical records sent is a complete non-issue for your current doctor and their practice. It happens all the time, nobody is going to be offended, and your doctor will honestly probably not even know that you had the records shared with another provider.

Your doctor does sound great, though, and not the type to be offended if you seek a second opinion. It might be more comfortable for you to frame it as "I wanted to do my due diligence" rather than "I felt like the care I was getting from you was somehow lacking." It really is normal to seek a 2nd opinion, and not a sign that your doctor is failing. As long as you remember that, it won't feel weird.
posted by vytae at 8:00 AM on October 24, 2011