A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions:
Is It OK To Get A Second Opinion?
Definitely. And therea??s no need to be secretive about it, or to worry about hurting the doctora??s feelings. Second opinions are routine in fields like oncology, and are often covered by insurance. Be up-front: Any decent oncologist can understand a cancer patienta??s need to find a doctor whoa??s right for them, with whom theya??re comfortable making important decisions. And in difficult cases, some specialists appreciate the chance to discuss the situation with another expert. So a second opinion can be beneficial to patients and physicians alike.
When things can get out of hand, though, is when patients start a??doctor shopping.a????For example, Ia??ve cared for some patients with leukemia whoa??ve been to see over 10 oncol?-o?-gists. If youa??re acutely sick, this sort of approach to illness can be coun?-ter?-pro?-ductive — it can delay needed therapy. From the physiciana??s per?-spective, ita??s alien?-ating: Who wants to invest her time, intel?-lectual effort, and feelings for a??patient whoa??s unlikely to follow up? Besides, oncology is the sort of field where each con?-sulting doctor may have a??dis?-tinct opinion. (If you see??10 oncol?-o?-gists, you may get??10 opinions.) Beyond a??certain point, it may not help to get more input, but instead will cloud the??issue.
As things stand, oncol?-o?-gists often discuss dif?-ficult cases with their col?-leagues. This happens at aca?-demic centers and hos?-pitals, where tumor boards meet reg?-u?-larly to review the diag?-nosis and man?-agement of each cancer case, and infor?-mally in private prac?-tices, where physi?-cians are likely to discuss certain aspects of treatment with their partners. For patients with very rare con?-di?-tions, some oncol?-o?-gists will call experts in the field whom they may know through national meetings, journals, and other resources. What this means for patients is that through one con?-sultant, they may be getting input of more than one expert, although they may not be??aware.
So I??rec?-ommend that patients with cancer, or any other serious or rare con?-dition for that matter, get a??second or third opinion about the best way to manage their illness. But at some point youa??ve got to select one among those spe?-cialists, even if shea??s not perfect, and stick with her at least for awhile, until you have a??good reason to switch or move on. Otherwise, youa??re unlikely to have a??doctor who cares when youa??re really sick and, later, about your long-term well-being.
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