When to get a second opinion

When actress Rita Wilson was told she had breast cancer in 2015, she made a personal decision to publicly reveal the news of her diagnosis, double mastectomy, and reconstructive surgery. What really made headlines, however, was that her cancer was detected only after she sought a second—and then third—opinion on her biopsy results.

Wilson is in good company. It’s not uncommon for people to find their diagnosis changes after seeking additional input. For example, one 2017 study of 286 patients at the Mayo Clinic found that 21 percent of those looking for a second opinion received an entirely new diagnosis. Another 66 percent had their existing diagnosis refined.

Given the value of early detection in cancer and other conditions, you may be wondering: When should I get a second opinion?

When to seek a second opinion

Many experts recommend getting a second opinion when the stakes are high. “And that doesn’t have to be cancer,” says Keith Roach, MD, associate professor in clinical medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital. You may want to get a second opinion before undergoing routine surgery or taking a course of powerful medications.

“The importance of a second opinion is two-fold,” explains Dr. Roach. “The more important reason is to avoid an error in diagnosis and to ensure proper treatment. The second reason is to provide a level of comfort and certainty to the person who is looking at the upcoming medical procedure.”

Pathologists and radiologists are experts at interpreting the results of cancer tests, but they’re not infallible. That’s why most healthcare providers (HCPs) agree that getting a second opinion is reasonable and do not get upset by a cautious person seeking them. “Double checking the pathology in the very first place before treatment starts can make a significant difference in terms of the outcome,” says Dr. Roach.

Michael Roizen, MD, Sharecare advisory board member and chief wellness officer at Cleveland Clinic, agrees. He says whether you’re looking at a mammogram, a pathology specimen or the need for antibiotics, many times the diagnosis and/or treatment changes with a second opinion.

In cases where the first and second medical opinions are at odds, “keep on going until you get consistency,” Dr. Roizen says. “We get very difficult cases here [at the Cleveland Clinic]. In fact, sometimes we get patients seeking fourth and fifth opinions. And if we still don’t know what’s wrong, we’ll say, look, we don’t know, but this is what treatment we’re going to try at first. If it doesn’t work, we’ll go another way.”

How to get a second opinion

Once you’ve decided to seek another provider’s point of view:

• Get a specialist recommendation from an HCP, health insurance provider, or the hospital or other medical facility where you were treated.
• Make sure your insurance plan will cover the second appointment.
• Ask that your medical records be sent to the second provider, request a copy to bring with you, or make sure you can access them electronically.

After your visit, request that your second provider send all relevant information back to your primary provider. Then, speak with your primary HCP about the opinions—together, you can determine the best path forward.