Americans visit physicians roughly four times per year. When people are dealing with more serious conditions, however, visits can be more frequent, and the decisions that arise from those visits can shape your future.
While we like to have faith in our medical providers, at the end of the day, a doctor is a person that’s as flawed as any other professional you may know. What makes things more complicated is that medicine is very interpretive.
That interpretation may make getting a medical second opinion a necessity.
Are you unhappy with conversations or solutions that are arising from your visits to your physician? Are you wondering how to go about getting a different medical professional to weigh in?
Keep reading to get an in-depth overview of this topic and to have your questions answered.
Understanding the Problem
Studies have been conducted on patients and doctors to better understand their relationships. In these studies, patients have been asked how well they feel their conversations went with their physicians. The patient’s doctor received the same question.
When you look at results, it’s clear there is a divide between how well doctors think they’re listening versus how well patients feel they’re being heard. That conversational disconnect can lead to missed symptoms and, ultimately, an incorrect diagnosis.
The need to get a second opinion largely stems from patients feeling their concerns aren’t being properly processed or that their physicians don’t have an open-minded enough education in medicine to help them reach a less-conventional diagnosis.
What It Means to Get a Second Opinion
Getting a second opinion means going to a separate physician to have them assess the same medical problem as your primary physician.
We typically see three outcomes arise from obtaining a second medical opinion.
A second doctor can agree with your original diagnosis/treatment plan. A second doctor can diagnose you differently. Your second doctor might even agree with your diagnosis but recommend a different course of treatment.
If two physicians vary greatly in their interpretation of a patient’s condition, it’s not uncommon for patients to seek a third medical opinion to obtain some sense of consensus.
Second Opinion Hurdles
In theory, it should be easy to visit another doctor and ask them for their interpretation. Unfortunately, unless you have cash on hand, things are not that simple.
Two hurdles stand in the way of the average person obtaining a second medical opinion.
The Need for Referrals
To get help from your insurance provider in seeking a second medical opinion, you may need a referral from your doctor.
If you have a good relationship with your doctor, they’ll likely grant it to you. If you don’t, you may run into trouble.
It’s not unheard of for doctors to feel arrogantly confident in their diagnosis and refuse to honor requests for referrals to secondary general physicians or specialists.
Outright Insurance Refusal
Even with a referral, some insurance companies may deem your original doctor’s diagnosis satisfactory. That can result in refusal to pay for you to see another doctor.
If you’re able to obtain a referral, refusal from insurance companies to help pay for that visit is rare. Depending on your insurance usage patterns, though, overriding a referral is not unheard of.
Courses of Action
When you’re running up against a wall trying to get a medical second opinion, things might feel hopeless. Take heart in knowing that many have been in your situation. Several of those people have fought through their adversity to obtain their desired care.
Three common solutions employed to get a second medical opinion amidst physician or insurance push back include the following.
Paying Out of Pocket
If you have the money, nothing is stopping you from walking into a private medical practice and paying for a diagnosis. Without insurance support, this can be expensive.
Not only will you need to pay for your medical staff’s time, but you’ll also have to pay for tests that need to be conducted to arrive at your diagnosis.
Plead Your Case
Whether it’s a doctor that won’t give you a referral or an insurance company that won’t work with you, pleading your case can net positive results.
Most insurance companies have formal dispute processes you can undergo through their web portals. As you do this, be sure to pay close attention to details as misrepresenting any of your information is likely to result in another rejection.
As far as pushing a physician for a referral is concerned, talk to them via email explaining your situation and your need for assistance. If nothing else, your written plea creates a paper trail that can be helpful if more punitive actions need to be taken.
Threaten to Sue
We recommend avoiding legal action against doctors and insurers unless doing so is necessary. Sometimes though, bringing on a medical malpractice lawyer is your only option, and it can be very effective. When you feel you need someone in your corner, a lawyer can have your back.
Before you hire legal help, let your opposing party know you intend to do so. Sometimes, that threat of legal action is enough to force someone’s hand. Businesses know the expense involved in allowing for a second medical opinion is cheaper than fighting legal battles.
A Medical Second Opinion Can Save Lives
People are misdiagnosed every day. When those people trust their skepticism and seek a medical second opinion, they allow themselves to get the medical treatment they actually need, which can save their lives.
You should never give up on getting an additional perspective on your ailments if you feel the need to do so. No one will advocate for your medical care as much as you.
Fight for yourself and keep fulfilling your need to know by diving deeper into the lifestyle content on our blog.
