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Can I Get a Second Opinion?

by Dr. Brian S. Seaman, DC, FRCCSS(C), FICC

Have you ever had a problem that just wasn’t getting better? Seems to be taking longer than expected? Or is it not responding as it had in the past?

Probably most, if not all of us can say yes. Most times this type of thing happens because of factors such as:

  • Severity (how bad the episode is).
  • Duration (how long it has been bothering you).
  • Frequency (how often these type of problems reoccur).
From time to time, health care professionals also sees these type of problems;
  • An episode of lower back pain that is getting worse,
  • That shoulder problem that won’t go away,
  • The neck pain and headache associated from an acceleration/deceleration type of accident – commonly referred to as “whiplash” or,
  • That episode of chest infection or bronchitis (very common this time of year).

There are obviously many factors which can be contributing to each of these. Throughout any health care professional’s career, we will have seen many of these types of cases.

Health care professionals all realize the importance of good communication skills. However like anything in life, this can be a ‘two way street’.

If you are having concerns about any aspect of your health – especially if the condition is not responding as expected – then let your health care professional know. Contrary to popular belief, many of us have not mastered that fine art of ‘mind reading’!

So here are a few hints of things that you should think of, if bringing up such a problem with your health care professional and in particular if you want to inquire about a ‘second opinion’.

  • If you have had this condition before, think about how it is different this time (ie. frequency, duration, intensity, symptoms, etc).
  • Has the character of your pain changed? (ie. Is it ‘sharp’ rather than ‘dull’; is it a ‘burning’ type of pain?).
  • Is it affecting your normal daily activities? If so, specifically what?
  • If you are using medication (either over the counter or prescribed) is it no longer helping? (I often examine patients with chronic lower back problems who admit that the medication they are using has not helped in a long time. Many of them have not told their pharmacist or family physician; which I encourage them to do).
  • Have you developed other symptoms or health problems recently?
  • Are you more tired, is the pain awakening you at night, are you developing pain or tingling in the arms or legs, or have you lost any weight? All of these factors could be important to your health care professional.

So organizing your thoughts and jotting them down is not a bad idea. If you anticipate your health care professional may need extra time to consider your concerns, call ahead and talk to their staff. It is not good for you to feel rushed, nor for your health care professional to feel that he/she does not have sufficient time to fully address your concerns.

Whenever you see your health care professional, please do not leave your concerns to the end of the appointment. An “Oh, by the way…” as your health care professional is leaving the exam room is not the best way to initiate such a conversation. Explain first off, that you have some concerns and you would like to get some feedback or thoughts on the matter.

If your condition is such that your concerns are now very significant and depending on what your health care professional has suggested, you could certainly chat to him/her about getting a second opinion . Sometimes that extra ‘set of eyes’ is not a bad idea. So if you really want a second opinion, give some thought as to how you may want to ask. Being blunt may get you the second opinion that you want but may have an impact on your relationship with your health care professional.

Obviously some health issues are very complicated and an immediate answer to your concerns may not be possible. Your health care professional may want to take some time to review your case and schedule a follow-up appointment to discuss his/her impressions and recommendations. (Think about how thick some of your files may be!)

Depending on how well you know your health care professional, you may want to ask what they would do if they “were in your shoes”. In other words, if they were you, and given your current health issues, what would they do? It’s a fair question but one that, again, may necessitate them taking some time to review your file to think about what recommendations they will provide to you.

Now – if a second opinion is arranged please go prepared:

  • Confirm your appointment (time, date, location).
  • Organize your thoughts.
  • Ask your health care professional to send a referral note or even better a brief report outlining the reason for the referral.
  • Take along any available reports or x-rays.
  • And if you have a long, complicated history, a health summary in point form and in chronological order (with approximate dates) can be very helpful.

If additional testing is to be done, do it promptly (ie. x-rays or blood work) or if for advanced imaging (CT or MRI) follow-up with the specialist’s office or your health care professional to confirm the date.

So – what about that second opinion…sometimes it is a good idea but it does depend on your condition. Be sure to provide your health care professional with all the appropriate information. If your health care professional does not think it is necessary ask them to explain what factors they considered, so that you will have a better understanding and in turn help to allay any concerns you may have. You could also ask for a time parameter as to when the two of you should review the situation if your condition does not improve.

Hopefully these hints will help you better communicate with your health care professional.

Reprinted with permission of
The Seniors' Advocate. P.O. Box 5005, Waverly, Nova Scotia, B2R 1S2

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