Is there some sort of etiquette in getting a second medical opinion?
November 23, 2013 9:09 PM Subscribe
I haven't had many medical problems over the course of my life, but recently I had two (separate) "emergency" hospitalizations for a condition that I had been unaware that I had/have. (Complicated diverticulitis with perforation). Both hospitalizations were truly harrowing and have pretty much turned my life upside down. Very serious! In the hospital (the 2nd time) a surgeon who was on call told me that it really is not a matter of if I need surgery, but when I need surgery. (He says I need a colon resection).
What is ideal in this situation (I've learned) is that the patient waits for the colon to "calm down" (with antibiotics) and then more diagnostic tests are done (barium xray and colonoscopy). After that the surgery is performed.
Prior to the 2nd hospitalization I had a consultation scheduled with a surgeon who is well known (and kind of a star in the field) but his appointment is scheduled so far out I still haven't seen him. In the meantime I was "assigned" a surgeon at the hospital who has taken over my case. He seems fine, but he is young and obviously doesn't have the credentials of the star (who by the way is in the same office as the younger guy!). Now I have an appointment with both of them in the future.
I don't know if I will have the luxury of getting to wait for the star to see me and schedule my surgery....but since I have appointments with both of these surgeons coming up...I wondered if it is ok to ask the star surgeon for a 2nd opinion? (Even though he shares an office with the younger on call guy)?
Any advice you have is greatly appreciated. I feel sheepish about ditching the on-call guy...but it the star would take me, I'd probably want to go with him! I have no experience in these matters, and I probably sound nuts to you. I just want to try to effect the best possible outcome. Your thoughts are welcome.
What is ideal in this situation (I've learned) is that the patient waits for the colon to "calm down" (with antibiotics) and then more diagnostic tests are done (barium xray and colonoscopy). After that the surgery is performed.
Prior to the 2nd hospitalization I had a consultation scheduled with a surgeon who is well known (and kind of a star in the field) but his appointment is scheduled so far out I still haven't seen him. In the meantime I was "assigned" a surgeon at the hospital who has taken over my case. He seems fine, but he is young and obviously doesn't have the credentials of the star (who by the way is in the same office as the younger guy!). Now I have an appointment with both of them in the future.
I don't know if I will have the luxury of getting to wait for the star to see me and schedule my surgery....but since I have appointments with both of these surgeons coming up...I wondered if it is ok to ask the star surgeon for a 2nd opinion? (Even though he shares an office with the younger on call guy)?
Any advice you have is greatly appreciated. I feel sheepish about ditching the on-call guy...but it the star would take me, I'd probably want to go with him! I have no experience in these matters, and I probably sound nuts to you. I just want to try to effect the best possible outcome. Your thoughts are welcome.
Definitely don't feel bad about doing what is best for you. Although recent graduates may be trained in more cutting edge surgical techniques, whenever you're having a serious surgery done, you want a guy who does them frequently and has them down to an art. Forget etiquette, this is your life and your health. Your on call surgeon should understand if you decide to go with the well respected surgeon, and if he doesn't, I wouldn't spend even a moment sweating it.
posted by treehorn+bunny at 9:22 PM on November 23, 2013 [6 favorites]
posted by treehorn+bunny at 9:22 PM on November 23, 2013 [6 favorites]
Don't hesitate! I've never had a doctor blink an eye when I've mentioned getting a second opinion. When they're the patients, doctors get second opinions too. Also, there is nothing wrong with telling Doctor A what Doctor B said to get her take if the opinions diverge -- in fact, it can be helpful.
posted by Wordwoman at 9:26 PM on November 23, 2013 [1 favorite]
posted by Wordwoman at 9:26 PM on November 23, 2013 [1 favorite]
Definitely get a second opinion, and a third, if necessary. When I had colon cancer a few years ago, I moved heaven and earth (and waited an extra few weeks) in order to get a third opinion from the hot-shot, rising-star specialist surgeon that I really wanted to see. It was ABSOLUTELY worth it. This is exactly the situation where you want to make sure you've got all the info you need to make a good, well-informed choice, and no doctor is going to bat an eye under the circumstances if you want to get a second opinion.
posted by scody at 10:47 PM on November 23, 2013 [1 favorite]
posted by scody at 10:47 PM on November 23, 2013 [1 favorite]
If you have an actual perforation of the colon, you need to get your second opinion done as soon as you possibly can. If it's going to take several days to see the "star," you'd do better to get a second opinion, if you really want one, from another surgeon instead, and soon.
I postpone everything I can, but I wouldn't put that one off. A colon perforation can make one melluva hess.
posted by aryma at 11:10 PM on November 23, 2013 [1 favorite]
I postpone everything I can, but I wouldn't put that one off. A colon perforation can make one melluva hess.
posted by aryma at 11:10 PM on November 23, 2013 [1 favorite]
The etiquette for getting a second opinion is to inform your doctor that you're getting one. And then go get one. They don't take it personally. Most of the time, anyway.
Doesn't sound like you've got much time though. If you can't get one this week, it sounds like your condition might be serious enough that you can't afford to wait.
posted by valkyryn at 2:28 AM on November 24, 2013 [1 favorite]
Doesn't sound like you've got much time though. If you can't get one this week, it sounds like your condition might be serious enough that you can't afford to wait.
posted by valkyryn at 2:28 AM on November 24, 2013 [1 favorite]
Get your consultation with the Star. Call the office back, explain that you've been hospitalized twice and that a perforation was detected. Beg them to move your appointment up and/or ask if you can be called if an opening suddenly happens.
You'll be surprised, doctors want to accommodate their patients. I'll bet they'll find a place for you.
posted by Ruthless Bunny at 7:42 AM on November 24, 2013 [1 favorite]
You'll be surprised, doctors want to accommodate their patients. I'll bet they'll find a place for you.
posted by Ruthless Bunny at 7:42 AM on November 24, 2013 [1 favorite]
You do not need to notify the younger surgeon that you are seeking a second opinion. It is very common to choose not to work with the doctor who is assigned to you during a hospital stay.
What you should do is contact the office of the superstar surgeon and explain that you have recently been hospitalized again, and you've been informed that if your surgery is to be elective (instead of emergent) it needs to be scheduled soon, and you would very much appreciate being squeezed into the surgeon's schedule for a consultation sooner. An even better option would be to have your doctor (your GI or PCP, whoever is managing your care) contact the surgeon's office directly on your behalf (with the same sentiment).
For what it's worth, I was in an extremely similar situation last year -- I needed a colectomy and had a relatively inexperienced surgeon "assigned" to my case when I was hospitalized. When I was discharged, I tried to get an appointment with the top surgeon, and I was told there was a three month wait. My GI contacted the top surgeon's office on my behalf, and I had my consultation and subsequent surgery with the top surgeon within a week and a half.
posted by telegraph at 7:43 AM on November 24, 2013 [2 favorites]
What you should do is contact the office of the superstar surgeon and explain that you have recently been hospitalized again, and you've been informed that if your surgery is to be elective (instead of emergent) it needs to be scheduled soon, and you would very much appreciate being squeezed into the surgeon's schedule for a consultation sooner. An even better option would be to have your doctor (your GI or PCP, whoever is managing your care) contact the surgeon's office directly on your behalf (with the same sentiment).
For what it's worth, I was in an extremely similar situation last year -- I needed a colectomy and had a relatively inexperienced surgeon "assigned" to my case when I was hospitalized. When I was discharged, I tried to get an appointment with the top surgeon, and I was told there was a three month wait. My GI contacted the top surgeon's office on my behalf, and I had my consultation and subsequent surgery with the top surgeon within a week and a half.
posted by telegraph at 7:43 AM on November 24, 2013 [2 favorites]
You do not need to notify the younger surgeon that you are seeking a second opinion.
Technically no, but it's still a good idea. Two reasons.
First, your surgeon wants to know why you're not scheduling surgery right away. "I'm getting a second opinion" is a perfectly reasonable explanation. "I just haven't gotten around to it" is not. Given that meeting the standard of care involves correctly informing people about the urgency of the situation, the physician would need to do something different for each answer.
Second, most physicians will probably want to know what the other guy has to say! If the other physician gives a concurring opinion, hey, there's that much more reason to be confident in the diagnosis. If the other physician has the same diagnosis but recommends a different course of treatment, that's something for him to think about. If he has a completely different diagnosis. . . maybe somebody missed something. Here's an opportunity to learn from other people's experience.
Any given surgeon may or may not want to do the responsible/mature thing about a patient getting a second opinion, but I think you probably owe it to them to give them the opportunity to do so.
posted by valkyryn at 2:07 PM on November 24, 2013
Technically no, but it's still a good idea. Two reasons.
First, your surgeon wants to know why you're not scheduling surgery right away. "I'm getting a second opinion" is a perfectly reasonable explanation. "I just haven't gotten around to it" is not. Given that meeting the standard of care involves correctly informing people about the urgency of the situation, the physician would need to do something different for each answer.
Second, most physicians will probably want to know what the other guy has to say! If the other physician gives a concurring opinion, hey, there's that much more reason to be confident in the diagnosis. If the other physician has the same diagnosis but recommends a different course of treatment, that's something for him to think about. If he has a completely different diagnosis. . . maybe somebody missed something. Here's an opportunity to learn from other people's experience.
Any given surgeon may or may not want to do the responsible/mature thing about a patient getting a second opinion, but I think you probably owe it to them to give them the opportunity to do so.
posted by valkyryn at 2:07 PM on November 24, 2013
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posted by sevensnowflakes at 9:21 PM on November 23, 2013 [1 favorite]