An opinion on second opinions

When a patient says he or she wants to seek a second opinion from another physician, it’s natural to feel somewhat territorial or even offended. However, if you approach second opinions with the right mind set, they can be good for you and for your patients. They also can be good business.


Aniruddha Malpani, MD“Asking for a second opinion doesn’t mean that your patients don’t trust you. It just means that they need to be sure that they have covered all of their bases.”
-Aniruddha Malpani, MD, medical director of Malpani Infertility Clinic in Mumbai, India


Not only am I okay with my patients suggesting that they seek second opinions, I often go so far as to[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] encourage my patients to get second opinions when they are not sure what to do next. Sometimes, it’s obvious they are not happy with the advice that I have given them, and it can be helpful if they obtain a second perspective from an independent physician. I’m quite happy to suggest names of physicians whom I respect to ensure that they get a reliable, useful second opinion; or I tell them that they can find another doctor on their own.

Key Point: Patients who seek second opinions are simply doing their due diligence to ensure that they know all of their options. You can gain their trust by supporting these requests and providing detailed information to the next physician to inform his or her clinical opinion. If the physician providing the second opinion agrees with your recommendations, you build even greater trust with the patient. And, if the opinion varies, you may simply agree to disagree—or you may find that you have expanded your knowledge base.

I make it a point to document all of my findings and explain the rationale for my clinical recommendations, so that patients can have more productive conversations with the next doctor, who can then give them a more informed second opinion.

Asking for a second opinion doesn’t mean that your patients don’t trust you. It just means that they need to be sure that they have covered all of their bases and have explored all of their options. I am fine with this type of collaborative approach, because I don’t claim to have a monopoly on wisdom. I am quite happy to work with my patients to craft a treatment plan that is in their best interest, and that sometimes includes obtaining perspectives from more than one clinician.

If the second opinion is very similar to mine, this outcome leads to the patient having more confidence in my judgment, so that they are more willing to trust me. However, if they choose to go down a different treatment path, that’s fine, too. Sometimes this is just a personal preference on the patient’s part, and other times, the outcome allows me to learn and helps fill gaps in my knowledge base.

It’s important that patients trust their doctors, but we also need to earn that trust. A patient who wants to independently verify what you are telling him or her is only doing his or her due diligence. That’s why you should not only welcome these types of requests, you should sometimes encourage them.

Aniruddha Malpani, MD Dr. Malpani is medical director of Malpani Infertility Clinic in Mumbai, India, medical director of the HELP-Health Education Library for People, and author of a physician and patient education blog. He is an angel investor in Plus 91, which offers customized Web sites for doctors.

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One Comment

  1. Rakesh Khera
    Posted Dec 2012 at 2:43 pm | Permalink

    Most patients these days seek a2nd opinion, specially before undergoing a surgery. Most of us physicians don’t even know that this has happened or is happening all the time. It is very unusual for a patient to ask the primary treating doctor the name of the doctor they want to seek a 2nd opinion from, so i disagree with the author here. They rather do it on their own and it is their right anyway.

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