Help! I Don’t Want to Be Rude, But I Want a Second Opinion

By Steven Petrow

Published Mar 20, 2014

Dear Mr. Manners: Recently I was diagnosed with cancer. After being evaluated at an excellent cancer center and given a treatment protocol, I decided that I wanted to get a second opinion. I asked my oncologist for suggestions, but he said I was in good hands and didn’t need to get one. When I asked him again for someone to recommend, he seemed offended. So here’s my question to you: Did I do something wrong — or is there a better way to ask for a second opinion? -Desperately Seeking Help
A: Your question surprised me, as I thought oncologists in particular supported the idea of second opinions. It did not, however, surprise the three physicians I queried (or phase many of my Facebook followers). Joseph Spaulding, MD, a retired oncologist, told me that the response you received likely “reflects the inherent self-confidence” of the practitioner (a good thing) but could also be a reflection of “personal insecurity” (not such a good thing). Regardless, he said: “It is a reasonable consideration to see a second set of thoughts. You are the consumer and this is an important decision.”
Joseph O. Moore, MD, a Duke Medicine oncologist, emailed me much the same take: “Many physicians take personal affront with any questioning of their abilities, including have another physician review their work.” And  Mark Liponis, MD, corporate medical director at Canyon Ranch, noted that most doctors “don’t like to be ‘told’ what to do, but asking for referrals is usually fine.”
Patients on Facebook were more pointed in their criticisms of your oncologist’s response:

• “Best reason ever to seek a second opinion.”
• “You did nothing wrong; your current oncologist is behaving unprofessionally, and it’s time to find a second opinion on your own.”
• “There is a surgeon in my area who  — should he find out that a patient has gone for a second opinion — dismisses the person as a patient. It is hubris of the highest order.”

With all that in mind, here’s my advice:

1. Since docs can be just as insecure as the rest of us, don’t just say, “I’d like a second opinion.” Instead, ask your doctor, “Does it make any sense to seek a second opinion?” As Dr. Liponis noted, “The doctor will usually perceive the benefits of a second opinion to them, i.e., another expert who confirms their advice, that helps to reduce their own liability and reinforces their own expertise.”
2. Be up front with your “first-opinion” doctor that you’re not questioning his or her skill (or knowledge) but rather seeking the peace of mind that no stone has been left unturned.
3. Referrals don’t need to come directly from your first doctor: Ask friends or your primary care physician; check out doctor rating services or the tools provided by most health insurers.
4. If your doctor objects or isn’t forthcoming about a referral, move on— quickly. That’s not a good sign.

Most of the time, second opinions confirm an original diagnosis and treatment plan. When they don’t, well, that’s important to know too. As for how a physician might ideally respond to the sort of request you made to yours, how about this? “That’s a great idea. Let me get you some names, stat.”
What’s been your experience in asking for a second opinion?