喵咪社区

Second opinions in health care are wise for many reasons, says a 喵咪社区 oncologist.

Telling your doctor you want a second opinion isn鈥檛 always easy. Patients may worry about offending or jeopardizing their relationship with their doctor by consulting another provider.

But no one should be afraid to seek a second opinion, says Minh D. Nguyen, MD, a medical oncologist with the 喵咪社区 Norris Comprehensive Cancer Center, part of 喵咪社区. In fact, the valuable information a second opinion yields often helps not just the patient but their physician as well.

How second opinions help patients and doctors

There usually aren鈥檛 drawbacks to getting another physician鈥檚 input, Dr. Nguyen says.

First off, 鈥淒octors are human, too,鈥� he points out. Double-checking your physician鈥檚 diagnosis and treatment plan is never a bad idea, especially if a patient is facing a brand-new diagnosis they want confirmed, or if they are facing a life-threatening disease. In general, he says, 鈥淭hese patients are not afraid to ask for a second opinion because they want to be sure they鈥檙e making the right choices.鈥�

Consulting another doctor is especially helpful if a disease or condition is rare, complex or lacks a long-established standard of care. A second physician may be able to suggest additional treatment options that haven鈥檛 yet been considered.

鈥淚f a patient has a rare type of tumor, or a rare leukemia or lymphoma, for which there isn鈥檛 a standard of care, getting a second physician鈥檚 insight can open other treatment pathways I hadn鈥檛 considered,鈥� Dr. Nguyen continues. 鈥淲e can evaluate and compare our recommendations to help the patient decide which approach they prefer. I can say, 鈥楾hese are the reasons I recommended this, but I can see why the other doctor recommended that.鈥欌��

When patients do come to him for a second opinion, he tries to evaluate each case with fresh eyes. 鈥淚f it鈥檚 a new diagnosis, I tell the patient not to tell me what the other doctor said,鈥� Dr. Nguyen says. 鈥淟et me look at your data and formulate my own opinions objectively. After that, you can tell me what the other doctor said, and we can compare notes.鈥� But, he says, if a patient鈥檚 disease is very complex or advanced, then it helps to hear the other doctor鈥檚 history of diagnosis and treatment at the start before forming his recommendations.

In either case, he remains neutral when delivering his own recommendations. 鈥淣umber one, I don鈥檛 want to say any bad or good things about the other doctor; I want to remain neutral,鈥� he explains. 鈥淎nd number two, I don鈥檛 want the patient to feel like they didn鈥檛 get the right care.鈥�

Another reason consulting another provider can help is that the provider might know of a clinical trial that could benefit the patient. 鈥淚 would certainly encourage patients to see what other trials are out there,鈥� Dr. Nguyen says. 鈥淥ftentimes, I鈥檒l look for open trials for patients 鈥� either here at Keck Medicine or elsewhere. If I see a clinical trial somewhere else that looks promising, I鈥檒l tell them, 鈥榃hy don鈥檛 you get a second opinion with those guys?鈥欌��

Finally, another reason to get a second opinion is if current treatments aren鈥檛 helping. 鈥淧atients who have been diagnosed with a disease for a long time and whose disease is still progressing even though they have been through a lot of treatment鈥� can request a second opinion to seek new ideas for treatment, Dr. Nguyen says.

Second opinions can be reassuring

Overall, having another physician evaluate a case anew can help all parties feel more confident in final diagnosis and treatment decisions.

Dr. Nguyen says he finds second opinions helpful because they can validate his original recommendations to a patient. 鈥淧ersonally, I welcome them because, the majority of the time, the second opinion will come back saying what I said,鈥� he notes.

鈥淎 lot of the common tumors we treat like breast cancer and colon cancer 鈥� we see those cases all day long, and they have standard protocols and straightforward pathways already established nationwide that most doctors agree on,鈥� he continues. 鈥淪o, when another doctor provides their second opinion, it will reinforce my own recommendation to the patient, and it will give them more confidence in the treatment plan. It will allow them to be more at peace with the plans we鈥檝e discussed because another physician has independently recommended the same thing.鈥�

If both doctors鈥� treatment plans are valid and would be equally effective, it can be left to the patient to decide which they prefer. 鈥淚f the patient decides to follow a different treatment recommended by another doctor, but it鈥檚 still an acceptable treatment pathway that I can provide, I don鈥檛 have anything against that,鈥� Dr. Nguyen says. 鈥淚鈥檓 more than happy to administer that treatment.鈥�

A good doctor won鈥檛 be offended

Despite the benefits of a second opinion, some doctors do get offended when their patients ask for one. 鈥淚t happens,鈥� Dr. Nguyen says. 鈥淚鈥檝e had patients come to see me for a second opinion who have said, 鈥楳y doctor wasn鈥檛 happy I鈥檓 getting a second opinion. They told me if I do so, don鈥檛 come back. If you walk out the door, keep walking.鈥欌��

For the most part, however, he believes most physicians do welcome patients getting second opinions. And if a patient wants one, he believes it鈥檚 in everyone鈥檚 best interest to be as helpful as possible.

Doctors should be supportive, especially if a second opinion would bring their patient peace of mind. In fact, Dr. Nguyen says, he offers to review lists of other physicians his patients are considering seeing and will provide feedback on who he thinks would or wouldn鈥檛 be the best fit. 鈥淚f you鈥檙e going to take time to get a second opinion,鈥� he says, 鈥渢hen get it from the best of the best.鈥�

Most of the time, he adds, his patients will consult him when they鈥檙e thinking about getting a second opinion. 鈥淭hey鈥檙e very forthright with me,鈥� he says. 鈥淭hey鈥檙e not ashamed about it or scared to ask. A lot of that has to do with the physician-patient relationship. If they鈥檝e known me for a while, they鈥檙e comfortable bringing it up and asking.鈥�

That鈥檚 the way it should be, he says. 鈥淭he diseases we deal with are life-threatening diseases, and you want the patient to be at peace with what they are doing. I think all physicians should encourage second opinions when the patient asks for it. The more you can put them at peace, the better the treatment will go.鈥�

Are there exceptions?

If there is still time to seek a second opinion, physicians should support their patients鈥� wishes. There are a few instances, however, when Dr. Nguyen says he might push back if a patient wants to pursue additional consults.

One example is when a patient鈥檚 disease is aggressive and the patient needs to start medical treatment right away.

鈥淚 do welcome second opinions as long as there is time for it,鈥� Dr. Nguyen explains. 鈥淚f there are diseases that are very aggressive, moving at a fast pace and I think we they need to get on treatment right away, I鈥檒l tell the patient, 鈥業 don鈥檛 know that you have time for a second opinion. You need to start treatment. You can still seek that second opinion but do it after you start treatment.鈥�

鈥淎s long as there is time for getting second opinions, however, I encourage it,鈥� he says. 鈥淚 tell the patient we can start treatment in the next three or four weeks. There鈥檚 time. Go ahead, go over there and get an opinion, then come back and let me know what you find out.鈥�

In addition, Dr. Nguyen says, he may voice his opinion if he doesn鈥檛 believe an alternative treatment will work.

Take holistic treatments, he says. 鈥淚 tell the patient I don鈥檛 have data to support those holistic treatments. If they want to undergo those treatments in combination with the treatments I鈥檓 proposing, and as long as those holistic treatments aren鈥檛 damaging, I鈥檇 be okay with it 鈥� but I won鈥檛 provide those holistic treatments myself. The patient would have to go to a holistic doctor for that.鈥�

Don鈥檛 be afraid to ask for a second opinion

The bottom line is that a good doctor will support their patients, Dr. Nguyen says. If you want a second opinion, do not worry about offending your current doctor. Second opinions are not only an accepted part of health care; they are the patient鈥檚 right.

If you need a second opinion, the cancer experts with the 喵咪社区 Norris Comprehensive Cancer Center can help. As leaders in cancer research, our renowned doctors and specialists use the latest cancer detection, prevention and treatment options to help you get the care you need each step of your cancer journey.

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Jennifer Grebow

Jennifer Grebow is manager of editorial services at 喵咪社区.

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