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.
In this article, we’ll walk through the signs that it might be time for a second opinion and how to advocate for yourself while still building strong, collaborative relationships with your healthcare team.
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 an 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, her first doctor told her to take ibuprofen and return to work—despite the sharp, daily pain she was experiencing.
Although the doctor didn’t see any issues, she knew something was wrong.
Even with her medical background, it took multiple opinions and nearly a decade to find a specialist who could identify the exact issue and provide effective treatment. Unfortunately, De’Ja’s story isn’t unique.
Many patients—especially those with chronic or complex conditions—feel rushed, unheard, or uncertain about their care. Often, this isn’t due to negligence on the provider’s end, but a result of time constraints and pressure within today’s healthcare system.
If you’re still left with questions, seeking a second opinion can be a productive next step. It’s not about challenging your provider, but instead about gaining clarity, exploring options, and feeling confident in your care.
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 seems rushed or your concerns aren’t fully addressed. While time constraints are common, you still deserve clear communication. If you consistently leave confused, it may be time for a second opinion—or to use tools like Guava to help focus the conversation.
- 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. This means that many conditions affecting these groups are less understood and it can take longer to reach a correct diagnosis or receive appropriate care.
That said, it’s also important to recognize that many conditions—especially complex ones—don’t come with clear-cut answers right away. Diagnosis is often a step-by-step process, where providers work through possibilities over time. While this can feel discouraging, especially if you've already faced dismissal or bias, it doesn’t always mean your provider is wrong or untrustworthy.
Overcoming the Fear of Asking for a Second Opinion
Many patients worry that asking for a second opinion will offend their doctor. In reality, most providers support second opinions—especially when they’re approached as part of building a thorough, well-informed treatment plan. When done respectfully, second opinions can actually strengthen the patient-provider relationship.
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 while keeping evidence-based information in mind.
“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 can bring valuable insights, confirm a diagnosis, or offer a new direction—but it’s not about mistrust or proving your provider wrong. It's about building a healthcare team that works with you, not just for you. Your voice matters, and when paired with strong provider relationships, it becomes a powerful tool for better health outcomes.
