Why Second Opinions Matter
In medicine, second opinions are often a crucial step toward achieving an accurate diagnosis and appropriate care. In 2017, a study performed by the Mayo Clinic showed that 21% of patients who sought a second opinion received a completely new diagnosis, while 66% had their initial diagnosis refined or redefined. In only 12% of cases was the referral diagnosis the same as the initial one. Although striking, this statistic won’t be surprising to those who suffer from chronic illness.
A Dual Perspective: Insights from a Nurse and Patient
If anything has been learned from entering a new age of personalized healthcare, it’s that you are your own strongest advocate. De’Ja Wrought Brunson, a registered nurse (RN) who has spent years both treating patients and navigating the healthcare system herself, learned this lesson firsthand.
De’Ja is a registered nurse (RN), a Guava Patient Advisory Board member, and a patient herself. She suffers from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and severe back pain.
When De’Ja injured her back early in her nursing career, the first doctor she went to dismissed her concerns, recommending that she take ibuprofen every few hours and return to work. This was despite the fact that she was experiencing daily sharp, unrelenting pain. Although the doctor didn’t see any issues, she knew something was wrong. Despite her familiarity with the medical system, it took multiple opinions and nearly a decade to find a specialist who recognized what was really happening.
Unfortunately, De’Ja’s story isn’t unique. As a consequence of the current state of the US medical system, many patients feel unheard, rushed, or dismissed by their providers. This leads many to seek out second, third, or fourth opinions in order to move forward with proper care. In this article, we’ll explore the signs that indicate you might need a second opinion and how to confidently advocate for yourself in the healthcare system.
Keep in mind that as a patient or patient advocate, you always have the right to seek a second opinion.
Signs You Need a Second Opinion
Recognizing when to advocate for yourself can be challenging, especially in clinical settings that can feel intimidating or disempowering. However, there are key red flags that can indicate when it’s time to seek a second opinion.
- Your provider rushes through appointments or dismisses your concerns without explanation.
- You feel like information isn’t being clearly explained or is going over your head.
- A major treatment or surgery is recommended without discussing alternatives.
- You have a gut feeling that something is being overlooked.
- You experience medical gaslighting—being made to feel like your symptoms aren’t real or don’t match your own experience.
For De’Ja and other people of color, getting a second opinion on your care can be particularly important, especially when it comes to rare or under-researched conditions. Biomedical research specific to Black people and other marginalized groups is underfunded, meaning many conditions are less understood and treatments can be less effective.
Overcoming the Fear of Asking for a Second Opinion
Many patients fear that asking for a second opinion might offend doctors or come off as disrespectful. The first step to advocating for yourself in this situation is to let go of that fear. As a minority navigating the healthcare system, De’Ja explained that she understands why many patients feel scared. As an RN, however, she emphasized that your care team is supposed to work hand-in-hand, not independently.
Collaboration is often key in building a successful treatment plan. While your primary care provider (PCP) should be your home base, they shouldn’t hesitate to refer you to a specialist if your symptoms seem out of their scope.
If you don’t feel comfortable sharing the fact that you’d like to seek out another opinion, you don’t have to. However, it may be a good idea to keep them in the loop about medications and to avoid repeated testing. Here are some things you can say to ask for a referral or second opinion politely while maintaining your assertiveness:
“I appreciate your perspective, but I’d feel more comfortable getting another opinion to be sure we’re on the right track.”
“Before moving forward with treatment, I’d like to consult another specialist to compare recommendations.”
How to Get a Second Opinion Without a Referral
Many specialists allow patients to schedule appointments directly without needing a referral, depending on your insurance and the type of care required. Here are some ways to seek a second opinion without a referral:
- Contact a specialist directly. Some providers accept self-referred patients, meaning you can book an appointment without a referral, particularly if you're paying out of pocket.
- Check your insurance policy. Some plans allow second opinions without a referral, especially for complex or rare conditions. Check with your provider to verify coverage.
- Explore telemedicine options. Virtual consultations can connect you with top specialists across the country, often without requiring a referral.
Before scheduling, ensure the specialist accepts your insurance or be prepared for potential out-of-pocket costs. You’ll also have to obtain your medical records from your initial provider by accessing your patient portal or contacting your provider’s office.
What to Bring to Your Second Opinion Appointment
Doctors are data-driven, so having numeric data on symptom history throughout the time leading up to the appointment can be quite useful. Due to the time constraints of doctor’s appointments, going into the visit with an agenda can help keep the information you need to communicate concise and focused. As a provider herself, De’Ja has a few tips for patients going into their doctor's visits.
- Prepare a written summary of symptom details, including start date, frequency, severity, and fluctuations.
- Provide relevant test results, scans, and lab work.
- Note treatments tried, including their outcomes.
- Bring a list of conditions and medical history.
- Be specific about timeframes.
- Go in with confidence.
How to Ensure Your New Provider Takes You Seriously
Walking into a second-opinion appointment with confidence can make all the difference in how you are treated. De’Ja noted that as an overweight Black woman, her symptoms were frequently misattributed to anxiety or weight-related issues, leading to delays in care and misdiagnoses. This kind of bias disproportionately affects marginalized patients, making it even more critical to advocate for yourself.
Here’s how you can ensure your provider takes you seriously, no matter your background:
- Come prepared with documentation. Bring a clear summary (or use Visit Prep) with symptoms, test results, and previous diagnoses.
- Use precise language. Instead of saying “I don’t feel right,” describe your symptoms with specifics: “I experience sharp, localized pain in my lower back that worsens after standing for more than 10 minutes.”
- Be direct but respectful. If a provider downplays your symptoms, don’t hesitate to ask, “Can you explain why you don’t think this is a concern?” or “What alternative explanations should we explore?”
- Bring a support person. A trusted friend or family member can help advocate for you and ensure your concerns are acknowledged.
- Know when to push back. If you feel dismissed, ask for documentation: “Can you note in my chart that my symptoms do not warrant further testing?” This often prompts providers to take concerns more seriously.
If the second opinion conflicts with the first, don’t panic. You can consider:
- Getting a third opinion to compare.
- Asking both providers about their reasoning.
- Talking to friends and family for guidance on your next steps.
“Sometimes it takes more than one second opinion. Sometimes, it’s a third or fourth opinion before answers come. I know it can be absolutely draining, but please don't give up hope.” — De’Ja Wrought Brunson, RN
Understanding Self-Advocacy in Healthcare
Self-advocacy is the ability to confidently express your needs, concerns, and preferences in the healthcare decision-making process. It means asking the right questions, pushing for answers, and ensuring you are receiving the best possible care. Many patients hesitate to speak up, but advocating for yourself is essential to getting accurate diagnoses and appropriate treatments.
You Are Your Own Best Advocate
De’Ja’s advice?
“Remember that even though doctors went to medical school, you’ve lived in your body your whole life. You are the leader of your healthcare team.”
A second opinion is never a bad idea—at worst, it confirms what you already know. At best, it leads to life-changing answers. Trust your instincts, ask questions, and don’t be afraid to stand up for your care.
