Should you go to another doctor for a second opinion?

Is the diagnosis correct? Is it the right treatment? Is surgery really needed? Are there any alternative options?

There are countries where a second opinion is mandatory mainly for insurance purposes, especially in the case of critical illnesses such as cancer. There are doctors in these countries who also explicitly state that they are second opinion doctors. These doctors give their opinion on the diagnosis or line of treatment but may choose whether to treat second opinion patients or not based on certain ethical guidelines. In India, however, there are no clear-cut rules on seeking a second opinion. Many old-school doctors expect that patients take their word as gospel and sometimes there is no room for seeking a clarification on the diagnoses or treatment, let alone asking them to refer someone for another opinion. The doctor-patient relationship is based on implicit trust and doctors could perceive the patient s desire to get a second opinion as a lack of trust or they are concerned about the second doctor poaching their patient.

Some patients try getting their information online on the sly. But, most doctors have come to abhor Dr. Google as they hate it when patients come to them with questions based on their searches and try to second guess the doctor.

Plus the healthcare system in India is very different and there is no common public health record. Also, no two doctors maintain records of your ailment and treatment in the same manner. Even hospital notes are not maintained properly sometimes. So it is difficult for you to go seek another opinion. The doctors may ask you repeat tests, which becomes an expensive affair. Sometimes, even for a dental treatment, the dentist may ask you to redo the dental x-ray at their clinic even if you get the previous scan. The reason could be as vague as the previous scan is not clear. In this scenario seeking a second opinion does not seem like a viable option.

Many patients in India usually go to a general physician or family doctor and then approach a specialist only if their doctor recommends one. This works best when one doctor is aware of the patient s entire medical history and has won their trust by recommending specialists such as ENTs or surgeons if and when they require the attention. Many old school general physicians are known to prescribe medicines for any and every condition from diabetes to depression. The patients of our parent s generation did not even know the difference between a branded drug and a generic one, let alone the type of medication and blindly followed their doctor s advice.

Our approach to health is also changing as more and more patients are not only googling information about their symptoms but also seeking medical advice on online portals. And in today s times, there are some doctors who choose to point their patients to relevant online resources to cross-check information and encourage them to google but armed with the correct information. In this scenario shouldn t doctors be encouraging a second opinion from a qualified professional who they trust? Well, whether the majority of Indian doctors recommend specialists or not, at TheHealthSite.com we have had different doctors recommend how to be a more informed patient and why we should be seeking a second opinion.

IVF expert Dr Anirudh Malpani has explained in detail on how to choose the right IVF specialist so you are not disappointed due to the lack of success after a long and expensive treatment. With IVF clinics mushrooming in every other lane in India, Dr Malpani s words of caution and practical advice will help you identify a good IVF clinic and protect yourself from scams or sub-standard treatment.

Just as most Indians are aware of IVF treatment for infertility, when it comes to surgery, knee replacement surgeries have almost become fashionable in India. According to Dr Pradeep Moonot, Orthopedic surgeon, most of these surgeries are completely unnecessary. He advises you to avoid a knee replacement surgery unless it is critical. So it makes sense for you take a second opinion before a knee replacement surgery.

But, whether you are an informed patient or not, there are certain situations where you not only seek a second opinion but are concerned whether you need to change the doctor. For example, if your symptoms worsen or you do not get any relief, then you might seek another doctor. Sometimes, a doctor may be good but might not be able to or willing to give you an explanation for their course of action. Then, for your peace of mind, it is better to cross check with another specialist. Sometimes, doctors are not sure about what a certain test report indicates, say, when a spot on an X-ray or MRI that could be one of many things. They may choose to consult other experts and then give you a diagnosis. Sometimes the reports may indicate the same thing and there is no room for interpretation but the treatment option may be subjective. For example, an ultrasound may reveal an enlarged prostate but whether it is acceptable or needs surgery is a call the doctor needs to take. In such cases, you could also try to get another expert to confirm the treatment plan.

Even if it is not a life-threatening condition or a tough diagnosis, you can and should seek a second opinion in these circumstances:

To get a confirmation on the diagnosis and prognosis

Sometimes the doctor s opinion may not confirm the diagnosis or he may not agree with the prognosis or the possible outcomes. In such a case, you need to evaluate the option of seeking a third opinion or choosing the expert based on patient reviews and feedback.

To know more the disease from the point of view of different specialists

This is not just for emergencies but also for chronic conditions like diabetes. Even if you are going to a diabetologist, say, you may still need a specialist in diabetic foot care or a nephrologist.

To know about latest treatment options, which your doctor may not be able to offer

From dentistry to urology, there is a range of treatment options which may or may not be available in your doctor s clinic or hospital.

To know more about cheaper or charitable treatment or care options

Seek multiple opinions when you are looking for cheaper alternatives to medicines or physiotherapists or charitable options. Just as Tata Memorial Hospital is synonymous with cancer, there are local hospitals and charitable trusts all over India that offer patient care or treatment for a very low fee or even for free.

To get recommendations on alternative treatments

Some doctors integrate alternative remedies such as Ayurveda or herbal remedies along with allopathic therapy.

To know about patient care options

Not all doctors may be aware of at-home nurses or attendants or care centres in your area. It is good to ask around and figure out which services they would recommend. Especially, in case of palliative care, where at-home care is not possible, you can ask for a reference to a good centre which is closer to your home.

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