Second opinion, how to ask doctor for?

  1. I have had shoulder pain for 14 months (fell down a hill ). Doctor suggests shoulder surgery (wants to look around for possible spurs or torn roator cuff that did not show up on MRI). I go back to MD on Friday, how do I ask for a second opinion? Can it be from someone in his own group or do I need to find another ortho group? Are MD's offended (where are you TiredMD?)? Do they welcome the second guessing? Can MD's in the same group be impartial? From what I have heard, shoulder surgery can be pretty wicked--I do not want to get it unless I HAVE to.
    My Nursing gig has been in OB and I am new to the area and stay home with my kids now. I don't fell "well-connected" in the community yet and I sure wish I had some RN friends I could ask about the ortho groups in town. NOT asking for medical advice! Have any of your all ever asked for a second opinion? How did things end up turning out for you? Thanks.
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    About dcampbell

    Joined: Jan '07; Posts: 130; Likes: 111
    Specialty: NICU. L&D, PP, Nursery


  3. by   RN1989
    Doctors generally do not welcome their pt's asking for a second opinion. I have seen people go to a partner without good results. They either don't really get a thorough exam because the original doc tells the partner what is going on, or they get the exact same opinion with the feeling that it was not impartial.

    If you truly want an impartial second opinion - find your own doc and don't tell the original doc that you are getting a second opinion. Don't let the original doc know if you or the new guy is requesting copies of xrays either. You would be better off getting new xrays with another doc, even if you have to pay out of pocket for them.

    Also, other docs do not always welcome being the second opinion. They feel like they are intruding if you tell them that they are a second opinion because you didn't trust/like what the first doc said. It makes them feel like there could be a hint of a lawsuit somewhere. I've tried to help patients get second opinions and had the doc refuse to see them based on those grounds. Of course they didn't tell the pt that but the doc's staff told me that in confidence.

    My experience has been that orthopods are quite arrogant for the most part and really dislike someone not taking their word as gospel.
  4. by   leslie :-D
    get a 2nd opinion independent of the 1st.

    that said, any reputable doctor 'shouldn't' have any problem w/you seeking another opinion.
    i haven't had the same experiences as rn1989.
    but if you want objective input, it is safest to get the opinion w/someone outside of the group.

    best of everything.

  5. by   SCUnursie06
    I recently went through this experience. I'm facing some GYN surgery & wanted a 2nd opinion on which procedures would be best. First I went to my "regular" GYN that I've been using for years, he told me what he thought and scheduled some test that needed to be done first. Later that day I called the nurse back & cancelled the tests & explained to her that I was seeking a second opinion & I would call back if I wanted to proceed with Dr. so and so. I Went to see the 2nd gyn (totally different group) & was up front that this was a 2nd opinion and she (the dr.) had no problem with it. The 2nd dr. basically agreed with what the 1st had to say, now I just have to decide which dr.
  6. by   aeauooo
    Quote from RN1989
    My experience has been that orthopods are quite arrogant for the most part and really dislike someone not taking their word as gospel.
    At my first hospital we had an acronym; TSFO: too sick for ortho.

    Remember that you are a paying customer and the doctor is a service provider - you're paying for her/his service. If you're not happy with it, it is your right to go to another provider.
  7. by   rnsrgr8t
    Now granted, I work in pediatrics and urology which is a whole other world, but the MD's I work with (who are surgeons) welcome it if patients want a second opinion. I feel that any reputable physician should be comfortable with that. We have patients that come to us for 2nd opinons all the time. We actually ask about it when they schedule the appointment. The reason being so we can get the previous medical records, see what has been done/recommended prior to the visit. Sometimes we agree with the previous recommendations, sometimes we don't. Medicine is not an exact science and often there is more than one way to address a problem. The only issue we have had is with some families wanting to play one MD against another to get the recommendations they want. When this happens, we are firm (but nice) that they have to pick which provider they want. One of the MD's I work with stated it best... we offer a service, we give them our advice based on our expertise and is up to the patient if they want to take our advice or not. If you want it, get a second opinon and not think one thing about i. Good Luck.
  8. by   Antikigirl
    Most of the MD's I work with would have NO probelm with someone asking for a second oppinion! They can refer you to one, or dependant on your can seek one.

    Now, I have NO fear of speaking my mind with doctors (and I do it kindly and with many different social graces I have learned over the years working with patients...LOL!). I will discuss my plan with my physician and discuss the REASONS I wish to have another oppinion! That way they understand it is not a diss against them, as much as a rational thing I must do for myself! (or if it is a diss...I simply don't go back to doctors that I do not communicate freely and comfortably with!!! Takes me a few seconds to make that call...and I have walked out of offices before saying thank you but I will pay for a physician I mesh better with).

    Also...really be truthful to yourself and find out the reason you wish to have that second oppinion! Is it because you fear surgery...and it you deep down don't trust that physician or know them enough to authorize them to perform surgery on you? Are you in disagreement with their assessment of the situation, and truely feel that other alternatives are open that they are not seeing? There are many reasons...and once you have a grasp on your own thought process...well the search will be a lot easier for you and you will know what to ask .

    Good luck and sorry to hear about your injury! I hope the best!
  9. by   TiredMD
    Two different questions I see in the OP.

    1) Will my current surgeon be offended if I tell him/her I want a 2nd opinion?
    Honestly, maybe. It's kind of an ego thing. "I have all this training and experience and you want some fool to second guess me?!" Most of the staff I train under not only accept these requests, they encourage them. Hell, I have one attending who demands a second opinion for every patient that he recommends an elective major surgery (Pediatrics guy, the parents love it). I'm going to actively encourage it myself once I get done with residency. Second opinions, at least intuitively to me, seem like a great way to shield yourself from malpractice suits down the road.
    But then again, we're still surgeons, and the ego comes with the package. They might be offended. They probably won't show it. 99.9% will handle in professionally. Seriously, it won't be the first time, no matter who the doc is.

    2) Should I ask for a second opinion even if it means risking offending my current doctor (who is just a really nice guy, and kind of cute . . . )
    Absolutely. 100%. Go get a second opinion. Do it now. Pay cash for the appointment, it's not that expensive and will probably get you in faster.
    At the end of the day, it's your shoulder. Long after your surgeon retires, you've still got that bum shoulder. Long after you get the surgery or don't get the surgery, and he tells you there's nothing else for him to do for you, you've still got that shoulder. Your money, your shoulder, your surgery (or your non-surgery).
    The patient-physician relationship is really personal. For you, since you're a nurse (who by definition is supposed to have this whole caring, personal thing going on with the people you take care of) you probably have even more of this going on. But there has to come a point where you step back and remember that it's your body, your cash, your time. If you don't like your care, find another doctor. If you are unsure, go get a second opinion. It's more than just your right, it's your responsibility. Like I said, it'll still be your shoulder . . .

    And yeah, find someone from a different group. There are a bunch of reasons for this, not the least of which is that sometimes physicians don't want to offend their partners by disagreeing with them. Also, a lot of groups combine people with different areas of experience and subspecialty training, so it may well be that your first doc is a shoulder-trained 'pod, and his partner you're getting a second opinion from actually mainly does spine . . .
    Last edit by TiredMD on May 13, '08
  10. by   dcampbell
    Let me just say that I have been floored by all the kind and very helpful responses to my situation. I just wanted to update you all on what happened today when I went to the doctor to discuss shoulder surgery. I had psyched myself up that I was indeed open to shoulder surgery and I had about 5 questions that I wanted to ask and depending on the responses I knew how I wanted to proceed. Sounds easy enough but you won't believe what happened. All along through my ordeal I have had neck pain along with the shoulder pain and always mentioned it to each MA and to the ortho. I have also had numbness, tingling, and my left hand gets colder that the other. When I asked about how this surgery would or would not affect my neck pain, he got kind of upset( he turned white actually) and said that I should go back to the neurosurgery guy that I had already seen in October. He also said that he did not think that I even needed the shoulder surgery (what the..?). Five minutes ago he was gung ho for it. O.K. so I walk on over to the neurosurgeon's office to schedule the appointment and I asked if I could make an appointment with someone else than the guy I had seen in October (not the one who sent me to the Ortho.--after listening to you all, I though a fresh pair of eyes would be a good idea). The receptionist said that I HAD to be seen by the same guy (lets call him DR. F). I asked why, and she said that office policy was that you HAVE to see the SAME MD for three years --no matter what. And then after three years you can request a new doctor but you must then fill out a form saying why you are requesting a new Dr. and that the old Dr. must give his permission for you to be released to someone else. It sounds like it would be easier to leave a bad marriage than to switch doctors in this practice. Honestly, if you were a doctor would you want to see a pt. that did not want to see you?
    Dr. F. I am sure could quite possible be the best Dr. in the world but I would like someone else. He kept interrupting me when I talked and had his head in my chart most of the visit. He did not examine me--I am serious, he did not lay a glove on me. Then he raced to the door and with his hand on the doorknob said, "You don't have any questions, do you?" Well I quess not. And after all that I was charged $250 for the pleasure.
    So tired and frustrated by today I am not sure what to do next. :uhoh21:
  11. by   TiredMD
    Quote from dcampbell
    So tired and frustrated by today I am not sure what to do next. :uhoh21:
    1) Get rest over the weekend
    2) On Monday, find a new doctor
    3) If you had to go through your PCP to get into Ortho/NSG, go back to your primary care doc, tell him/her that you had very bad experiences with those specialists, and ask for a referral to a different provider

    It's like breaking up with a boyfriend --> It didn't work out, oh well, time to move on.
  12. by   CHATSDALE
    it is expensive to get a second opionion because the initial visit is always more expensive and sometimes all they do on first visit is order tests and xrays
    get a new neuro in another group and ask him to call ortho guy, probably wouldn't hurt for you to call the ortho guy yourself and ask him what he suspected

    and i disagree with those who say that a good md wouldn't mind if a patient requested a second opionion...i have seen some very good mds get their nose out of joint when a patient requested 2n opinion
    i found this particularly true with foreign doctors, in many of the other countries they expect mds to be looked up and honored, their word is accepted w/o question
  13. by   TiredMD
    Quote from CHATSDALE
    it is expensive to get a second opionion because the initial visit is always more expensive and sometimes all they do on first visit is order tests and xrays
    It's real important to be upfront with the doc you're going to a second opinion for. When you call to make the appointment, tell them it's for a second opinion, and make sure you take copies of your medical record, and copies of all labs, films, and radiology readings. This is a pretty common reason for an office visit, especially in the surgical subspecialties, so likely the office will tell you all this when you make the appointment.
  14. by   dcampbell
    I am the OP of this thread and I just wanted to post an update.
    I was able to get a MA at the Neuro practice to talk to the original Neuro doctor who blew me off (remember the doorknob guy?) to "release me" as a pt. so that I could be seen by someone else in the practice. Remember our concern about another doctor being impartial in giving a second opinion? Well not to worry, I saw four other doctors in this same practice and NONE of them could agree! Some of the highlights in Dx: thoracic outlet syndrome, neuropathy, ect. Finally one of the Neuros told me that I was "at the end of the line" and needed to go to Pain Mnmt. That just kind of made me feel that they were giving up on me. Hello, Neurontin. But frankly with all the numbness and tingling and temp changes of my arm and the shoulder pain and the constant headaches I was willing to try it. I was concerned that after 9 doctors that I had not gotten the same Dx twice. When I got to the Pain Clinic I met with the NP first. She changed my life. She listened to me and spent 30 minutes with me. She "put her hands" on me and actually examined me. She felt around my neck and she said that I had the tightest scalenes that she had ever felt. She brought in the doctor that she worked with and her felt my neck and was shocked. The quote was "that must hurt like holy heck". No kidding. The two of them stayed with me and came up with the right Dx finally. TMJ. I did not have anything like that before but it must have developed after months of pain and PT after the fall down the hill (16 months by that point). The constant discomfort and inability to sleep was making me tense all the time and I was clenching my jaw and holding my neck toward the affected side for so many months that TMJ had developed. The doctor and the NP said that I should get the shoulder done and be treated for TMJ. They gave me a prescription for a muscle relaxant, and told me that they would "clear me" for the Ortho for shoulder surgery.
    I went to the Ortho and he couldn't wait to do my shoulder. In July, I had a subacromial decompression and it was one of the best decisions I have ever made. Six days after the surgery I felt like a million bucks. The doctor had written a prescription for shoulder rehab for 3X week for six weeks. I went after the PT and exercises so hard that I only needed 4 sessions. No one at PT could believe it. Now four months later my shoulder feels great and my TMJ is gone.
    The moral of the story is: Don't give up. Keep seeing doctors until you get someone to listen to you and help you. In my case the two different problems were confusing the doctors but in all honesty SOMEONE should have figured it our sooner.