Living Well Your doctor – even a trusted, longtime one – could be making a huge mistake...
Recently one of our readers, D.B., told us his story. Years ago, one incident left his heart racing, his mouth bone-dry, and his skin prickling and tingling from the adrenaline rush.
What set off that bodily reaction were just three words said in the span of a couple of seconds...
You've got cancer.
Specifically, it was prostate cancer. And his doctor immediately recommended aggressive treatment.
But D.B. didn't jump to schedule the appointment.
As a longtime reader who saw our issue on the truth about prostate cancer, he decided to seek a second opinion ("SO").
In doing so, D.B. avoided an unnecessary surgery, as well as lifelong, serious side effects.
An SO is where a second doctor (in the same medical field as the first doctor) independently reevaluates the original diagnosis and/or treatment.
It turns out that getting that an SO could more than likely drastically change your outcome. A 2021 BMJ Open systematic review of 33 global studies found that SOs led to clarified and changed diagnoses in 17% and up to 15% of cases, respectively. Among cancer patients, 42% of them ended up with a change in treatment after having an SO. And regarding cancer-surgery advice, researchers found major and minor discrepancies advice between opinions in 32% of cases.
Also published that year, a study from the Mayo Clinic found that an SO could slash the rate of incorrect diagnosis from 50% to 25%. Another study from 2017 found that nearly 90% of patients seeking an SO at Mayo ended up with a "new or refined diagnosis."
You might want one to confirm or disprove your doctor's original diagnosis and/or recommended treatment. Or sometimes, your insurance company might require that you get an SO to get a certain treatment covered.
As long as you're not in an emergency situation, get an SO if you think the first opinion could be wrong or if you're diagnosed with a rare or life-threatening condition. An SO might help clear up any confusion you might have about the diagnosis and/or treatment. You might also want a second set of eyes if the recommended treatment carries a lot of risks or if you're trying to narrow down a list of multiple treatment options. Or perhaps the current treatment isn't working and you're still sick – a specialist who devotes his entire career to treating the kind of problem you've got will likely know about brand-new clinical trials and treatment options.
But if you're worried about offending your current doctor by asking them about an SO, let me put it plainly: Screw their feelings.
It's your life that's at stake. And it's your body. You have a right to get someone else to weigh in, especially if it's a life-threatening diagnosis like cancer. In fact, we doctors do this all the time − bouncing ideas, diagnoses, and treatments off of each other. Collaboration is how doctors can exchange and share knowledge and experience. The more brains involved in treating someone, the more likely that all aspects and angles of the illness will get covered, resulting in better treatment.
Now, if your current doctor shows the slightest hint of taking offense to your request, that's a giant red flag.
Nothing infuriates me more than an arrogant doctor. You don't want someone else's foolish pride getting in your way of living a healthy, happy life.
Would you want to see your loved one bullied by the very person he or she is entrusting their life to?
Nope.
So why would you allow yourself to be cowed in the same way?
If your doctor acts insulted and dismisses your concerns, that's a clear sign that it's time to take your business elsewhere... to someone else who has your best interests at heart.
Don't be nervous about how to tell your doctor that you'd like an SO. Speak plainly, saying that you'd like an extra opinion before going through with treatment. You can also ask him for the name of a colleague or specialist that he trusts.
After you've let your doctor know that you're getting an SO, you'll need to request a copy of or transfer of your medical records to the second doctor. That includes things like your doctor's notes from visits, medical history, test results, and radiology scans.
When you finally meet with the new doctor or specialist, ask them...
- If the first opinion's diagnosis is correct or if another diagnosis is possible
- If you need the surgery and/or medication suggested by the first doctor
- If there are any other treatment options out there, and what their benefits and risks are
- What the prognosis or outlook is for your diagnosed condition
If the SO differs from the first opinion, you can go back to your regular doctor to discuss the new information. Or you may even wish to get a third opinion from another specialist.
Now, realize that an SO can come with some downsides...
The new treatment plan might end up costing more than the original one. There's also the lost wages from having to take time off of work. Don't forget about the money you'll spend commuting to the appointment, whether it's gas money, a train ticket, or pesky parking fees.
And, of course, there's the matter of whether or not your insurance plan will help pay for that SO. So I recommend you check with your insurance company on how your plan covers SOs. You'll also want to check, of course, if your new provider accepts your insurance plan. That includes virtual SO appointments, where the billing provider might be out of state (which may not jibe with your plan).
Your doctor is human – he or she makes mistakes like everyone else. You don't want to put yourself through any treatments with potentially dangerous side effects without the certainty that it's your best option.
Longtime readers know that my raison d'être for getting into the newsletter business is to empower people with the knowledge to live a better life.
If you enjoy – and want more of – my top, actionable ways to be your own advocate for your health and to grow your wealth, give my flagship Retirement Millionaire newsletter a test-drive. You can do so for a discount, right here.
What We're Reading...
- Did you miss it? Be careful with prostate-cancer testing.
- Something different: The Bloody Mary once had a "fishier" name.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
August 20, 2024