Getting a second opinion on treatment — when and how

This article provides guidance on seeking second opinions for medical treatment. Always discuss wanting a second opinion with your elder's doctor first. Good doctors expect and support patients getting second opinions.

There's hesitation that many adult children feel when thinking about asking for a second opinion about a parent's treatment. What if it offends the doctor? What if the doctor thinks you don't trust them? What if it complicates the relationship? These worries are understandable, but they shouldn't prevent you from getting a second opinion when something feels off.

Good doctors expect patients to seek second opinions. They understand it's reasonable to want confirmation about major medical decisions. They know that another perspective sometimes clarifies thinking. They're not threatened by this. The doctors who do feel threatened might be the ones you should be least inclined to trust without additional opinions.

The question of when to seek a second opinion deserves consideration. Some situations make it more obviously necessary. If your elder has been diagnosed with cancer and is being recommended chemotherapy, a second opinion is standard. If they're being told they need major surgery, getting confirmation makes sense. If they're being started on a medication class with significant side effect risk, another perspective helps.

But second opinions aren't just for major diagnoses. If you're confused about a treatment recommendation, that's reason enough. If your elder isn't improving on the recommended treatment, that's reason to seek another view. If something just doesn't feel right, that instinct matters.

Starting the conversation with your elder's doctor is usually the right first step. Say something straightforward: I'd like to get a second opinion on this treatment recommendation. Can you help me understand where to go for that? Most doctors will not only accept this request but might offer recommendations of specialists they respect.

Asking your doctor for a referral has advantages. They know good specialists. They know who might offer differing perspectives. They can send your medical records directly to the second opinion doctor, ensuring nothing gets lost. They maintain professional relationships that can help communication. Using their referral is often the easiest path.

If your elder has insurance, check whether a referral is needed for the second opinion. Some plans require referrals. Some don't. Some require that the second opinion come from a provider in the network. Your insurance company can clarify this. You might also check whether the second opinion will be covered. Sometimes it's covered. Sometimes the cost falls to you.

Finding the right doctor for a second opinion depends on the condition. For cancer, you might seek a second opinion at a major cancer center. For heart disease, you might go to a university hospital or specialized cardiac center. For less common conditions, you might need to go further afield. Your elder's doctor can guide you toward appropriate specialists.

There's also the question of how much information to share with the first doctor. Some people worry that telling the first doctor about seeking a second opinion will bias their care. This isn't reasonable, but the worry exists. Usually, you can simply mention that you're seeking a second opinion without naming the consultant. The first doctor doesn't need to know every detail.

The second opinion process usually involves a consultation. The second opinion doctor reviews your elder's medical records and history. They might do their own exams or tests. They talk through the diagnosis and treatment options. They offer their perspective on what they'd recommend. This might confirm the first opinion, suggest alternatives, or recommend something different entirely.

An important point is that a second opinion isn't binding. It's information your elder can use to make decisions. Maybe the two doctors agree, which is reassuring. Maybe they disagree, and a third opinion becomes necessary. Maybe they offer different approaches, all of which are reasonable, and your elder gets to choose among them.

When two doctors offer different recommendations, it's worth understanding why. Sometimes it's because they specialize in different approaches. A surgeon might recommend surgery while an internist recommends medication. Both might be reasonable, and it's your elder's choice which direction to pursue. Sometimes it's because one doctor is simply wrong. This is why getting the expert opinions is important.

The cost of a second opinion varies. Some insurance covers it fully. Some requires a copay. Some doesn't cover it at all. If cost is a concern, ask about it upfront. Some doctors offer reduced rates for second opinion consultations. Some hospitals do as well.

The timing of a second opinion matters when treatment is urgent. For many conditions, waiting a week or two for a second opinion doesn't change outcomes. For some conditions, delaying treatment could be harmful. Discuss with both your elder's doctor and the second opinion doctor what timeline is safe.

The records needed for a second opinion should be thorough. Medical records, lab results, imaging studies, previous treatment records, medication lists, allergy information—all of this helps the second opinion doctor make an informed assessment. Ask your first doctor's office to send everything or prepare a packet of records to take to the second opinion.

Your role in seeking a second opinion depends on your elder's capacity and preference. Some older adults want to handle this themselves and just need your support and encouragement. Some need you to do the legwork of finding a doctor, scheduling, gathering records, and attending the appointment. Some need you to take notes during the consultation because they won't remember details. Adjust your involvement to match your elder's needs.

Sometimes your elder resists a second opinion. They trust their doctor and don't want to question their judgment. They're tired and don't want more appointments. They're anxious about whether another doctor might say something worse. These are legitimate feelings worth addressing. Sometimes sitting with that resistance and exploring where it comes from helps. Sometimes you need to gently but firmly advocate for a second opinion despite their reluctance.

After the second opinion, you might need to synthesize the information. If both doctors agree, great. If they disagree, you might need to help your elder think through the different recommendations. What are the tradeoffs? What are your elder's values? What does your elder actually want? The doctors provide information. Your elder gets to decide.

Good medical care includes multiple perspectives. You're not being disloyal to your elder's primary doctor by seeking a second opinion. You're being thorough.

If your elder has been diagnosed with a serious condition or recommended significant treatment, seeking a second opinion is reasonable. Discuss this with their doctor. Work with their doctor to find an appropriate specialist for a second opinion. Use the second opinion as information to inform shared decision-making with your elder and their healthcare team.