If you are a person with multiple sclerosis, there are many reasons why you might want to seek a second opinion when deciding on which disease-modifying therapy to try (or whether to stay with a particular one) or the best way to treat one of your MS symptoms. However, once you decide that getting more input from another doc is a good idea, your confidence may begin to falter. I have adapted the following tips for easing the process of getting a second opinion from my book, The Multiple Sclerosis Manifesto: Action to Take, Principles to Live By.
Feel Confident In Your Decision To Seek A Second Opinion
There are many people out there who feel like they are cheating on their doctor when they seek a second opinion. I know it can be an awkward situation, unless your doctor brings it up himself. However, most doctors will be happy for you to seek a second opinion, as it will probably make you more comfortable with your final decision and even more adherent to the treatment prescribed.
I am not promising that your doctor will have a positive reaction, however. Occasionally, docs get angry, feeling like the patient doesn’t trust their judgment or is searching for something specific that the current doctor doesn’t agree with. I even had one person write to me and say that her doctor “fired” her as a patient when she asked for a second opinion.
Despite these potential negative scenarios, you must remember that this is your health, your body and your decision. You have every right to talk to other doctors about your situation. This is not about one doctor's ego – that should not even enter into the equation as you seek answers to complex questions about MS, which is not a well-understood disease, even by people at the top of their field.
Script For Asking Your Doc About A Second Opinion
Okay, I know that I can keep telling you that it is your right to get a second opinion and that you have nothing to be nervous about. Clearly, however, you are the one who has to discuss it with your doctor and I won’t be there, giving you a “thumbs-up” sign and whispering, “You go, girl (or boy).” So, I’m going to give you a little script to adapt and practice before you go.
Try something like this: “Hey, doc, I have an idea that would make me feel better about this whole thing. Why don’t we get another doctor’s input on the situation before moving forward? This is kind of a big deal to me and having another person weigh in would really increase my comfort level with any decisions. [Optional: Is there anyone you would recommend to help us with this specific problem?]”
I don’t see how anyone could be too offended by an approach like this. After all, you are just looking for someone to help out “the team.” Going in prepared with something like this may prevent you from blurting out something unfortunate in an emotional moment. Even if you are pretty sure that you are done with your neuro or that his decisions are not the right ones for you, words and phrases like “lame,” “idiot,” “I’d rather eat glass” are just not productive.
Ways To Optimize Your Second Opinion
Gather all of your own medical records and get them to the other doctor in advance. This includes MRI reports and films, doctor’s notes, other test results.
Make sure you get a report on the second doctor’s findings. The doc might not communicate with your primary neuro (although they are supposed to). Also, you will want this report for your records as well as to use to conduct any of your own research on the topic.
Make sure the second doc is board certified in the area of question. If you are going to go to the trouble of getting a second opinion, it is wise to go to someone who is up on the “latest and greatest” in their field. If you are seeking advice on an MS-specific problem, find someone board certified in neurology. If, however, you are looking for answers to problems around certain symptoms, find someone certified in that field. For instance, for help with urinary incontinence, you would seek certification in urology.
Make sure your insurance will pay. In some cases, especially when surgery or less common treatments are going to be tried, insurance companies will require a second opinion to verify the benefit to the patient and that it is indicated for the condition before they will agree to pay for the treatment or procedure. In other cases, insurance will not pay for a second opinion.
What If Doctors Disagree?
There will be times when your doctors have different opinions. Make sure that you ask specific questions about why they came to the conclusions they did. What evidence did they have? Why does one think a certain procedure is better than another for you? It may be that one doctor is relying solely on studies published in medical journals, while another doctor is basing his recommendations on what you have told him about yourself and how you have responded to treatments in the past.
It is never a bad idea to do a little of your own research on your condition, including even seeking a third opinion, before making a decision. In the end, however, you may have to “go with your gut” when choosing among treatment options or which diagnosis to believe.
