Getting a Second Opinion

Should you get a second opinion?

If surgery has been recommended to you, I think a second (or even a third) opinion is an excellent idea. Very few things in medicine are black or white, and there is a lot of room for differences of opinion. In the present managed care medical environment, many doctors will not take the time to discuss your situation with you. And many have not taken the time to be trained in the new minimally invasive treatments available. For most doctors, if they do not know how to perform a procedure, they will not discuss or recommend it to you.

When a new patient comes to see me for a second opinion, we ask them to bring all the notes from previous doctor's appointments and any test results that are relevant to the problem. If an ultrasound or MRI has already been performed, I like to look at the films myself so that I can come to my own conclusions about the diagnosis.

After a complete examination, we go back to my office to discuss the issues and answer any questions you might have. I often use illustrations to demonstrate what those findings are. At this point I make a list of one or more possible diagnoses and outline the treatments available for each problem. To be complete with this list, I usually include even those treatments I would advise against or those the patient has eliminated. Together we then go through the list and come up with a short number of options that are both medically sound and personally acceptable to the patient.

Family members or friends are welcome to join you and this is sometimes helpful to make sure all your concerns are addressed and to help you remember what is said. I usually suggest that you not decide on any specific course at the time of the first visit. I think these decisions are usually best made in the comfort of home, when there is time to think. Women are welcome to call me with any additional questions they might have.

What if you decide that surgery is right for you?

If you decide that surgery is right for your situation, you will need to choose the doctor to perform your surgery. There are a number of factors that should influence your decision. The first is to choose a doctor who will perform a procedure that fits your particular situation and problem. In most cases, you should have more than one option from which to choose.

The next concern is the skill of the surgeon. How many procedures does the doctor perform a month? How many procedures like the one you are requesting? How many of these procedures have they performed in women with problems like your? How many complications has the doctor had and what kind of complications were they? Studies show that experience makes a surgeon better. Surgeons who perform procedures frequently have lower rates of complications. But surveys show that many gynecologists perform less than one or two major operation a month. Choose your surgeon carefully.

It is also important to feel comfortable with your doctor. Do you get an opportunity to ask questions and are they answered? Is the doctor available by phone?

If you decide to have surgery, another visit should be set up with the doctor you have chosen to go over the specific details of the procedure you are to have performed. Again, it is nice to have someone accompany you. Once a decision has been made, we go over a paper called the "Informed Consent". Filling out this form, if properly done, encourages a frank discussion of what you should expect from surgery. It allows the doctor and patient to go over the details of the operation to be performed, the specific risks of the procedure, the alternatives to the surgery, and the possible consequences if the surgery is not performed. Basically, this is the time when you will hear all the risks and possible complications during and after your surgery. This is difficult and may feel as if it's the last thing you want to hear, but ultimately it will be quite helpful to you.

We are certainly not trying to erode your confidence at this point, but we are legally and morally bound to tell you about all the things that could happen. Most people's emotional reaction to this form is some fear, which is understandable. Just remember to be sure and hear the optimism in the fact that there are options available to help you.



Disclaimer: The ideas, procedures and suggestions contained on this web site are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.