All about 2nd Opinions

2nd opinion.... That phrase seems to stir up uneasiness amongst some people. "What will my doctor think? Am I being dramatic thinking I need one? Will insurance even pay for it?"

There is a lot of unknowns when it comes to getting a 2nd opinion, but getting a 2nd opinion can be a complete game changer.

There is a common misconception that if you get a 2nd opinion it means you don’t trust your first doctor. This is not true by any means. Any good doctor should encourage a 2nd opinion especially when a patient is facing a chronic diagnosis and treatment options aren’t clear.

Personally I have received 2nd or even 3rd opinions in all the specialties I see. Only 1 of my specialists that I see was the first opinion. Were all the other doctors bad? Not necessarily, they were just not the best fit for me. Not every doctor is going to be the right fit for every patient. Don’t feel bad asking for a 2nd opinion.

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Some common reasons to seek a 2nd opinion are-

1. You don't connect well with your doctor and/or don't feel like you can fully trust them.

2. You have a rare or hard to treat condition.

3. The treatment options are major decisions with lots of risks.

4. You are considering surgery.

5. You aren't improving.

Here are some benefits to having a 2nd opinion-

1. You can confirm that the recommended treatment option is the best choice or possibly find out there are other options.

2. You can see if another doctor makes you feel more comfortable/safe.

3. You can have someone re-look over your records and review your medical history ensuring nothing is being missed.

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Depending on the type of insurance you have, the ease of getting a 2nd opinion will vary.

If you have a PPO-

With a PPO you are able to self refer and receive 2nd opinions quite easily. If you stay in network your costs will be lower, but most PPOs even let you go out of network just at higher costs.

If you have an HMO-

It should be relatively easy to get a 2nd opinion if you stay within the HMO, you'll just have to get a referral from your PCP.

However, if you attempt to go outside of the medical group that is when it gets trickier. Patients are entitled to one one time 2nd opinion outside of the group, but it can be tricky to get that approved. If it is a patient requested 2nd opinion, you will have to request authorization yourself from your insurance. Personally it took over 4 phone calls to even get the process initiated. So if you aren’t successful the first time don't give up. Sometimes it just takes getting an insurance representative who is familiar with those requests. If you aren’t getting anywhere with the customer service representative, ask if there is a 2nd opinion department and if you can be transferred there. Be sure to write down the 2nd opinion authorization department's phone number if they give it to you. This will come in handy if you need to change anything with the 2nd opinion or ever need another one in the future. If you still aren’t having any success, reach out to your doctor's office. They deal with insurance more than you do and might have some tips for you to try.

Be mindful if you get the 2nd opinion approved this is often just for a one time consultation, tests and other procedures are not usually covered under this authorization. If you wish to continue with this doctor you will likely need to go back to your PCP and request they submit a pre authorization for further appointments.

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Getting a 2nd opinion is extremely important when you are facing hard treatment options or a scary diagnosis. Patients should never feel embarrassed to ask for a 2nd opinion and doctors should always encourage 2nd opinions. If your doctor is against you getting a 2nd opinion that is a big sign that you really should be getting one. 2nd opinions help set you up to make the best decisions for your health and are extremely valuable.

Feel free to leave a comment with any questions you have about 2nd opinions. If you found this helpful please share with your friends.