When should I get a second opinion?

Consider a second opinion for serious diagnoses like cancer, when major surgery is recommended, if treatment isn't working, when the diagnosis is unclear, if told nothing can be done, for rare or complex conditions, or whenever you have doubts. Second opinions are standard practice and good doctors welcome them.

Will my doctor be offended if I seek a second opinion?

Good doctors understand that second opinions are a normal part of medicine and will support your right to seek one. Most doctors have sought second opinions for their own families. If a doctor reacts negatively to your request, that itself may be a reason to look elsewhere. You can frame it as wanting to be thorough, not as doubting their competence.

Does insurance cover second opinions?

Most insurance plans, including Medicare, cover second opinions, especially for surgical procedures and cancer diagnoses. Some plans require second opinions before certain procedures. Check with your insurance about coverage and whether you need pre-authorization. Out-of-network second opinions may have higher out-of-pocket costs.

What if the second opinion differs from the first?

Differing opinions are common, especially for complex conditions. Ask each doctor to explain their reasoning. Consider which doctor has more experience with this condition. You might seek a third opinion from a major medical center. Discuss the different options with both doctors if possible. Ultimately, you and your parent must weigh the information and make a decision.

How do I get medical records for a second opinion?

Request records from the original provider's medical records department. You'll need to sign a release form. Ask for all relevant records: test results, imaging (on CD), pathology reports, doctor's notes. Allow time for processing—this can take days to weeks. Many providers now offer records through patient portals. The second opinion doctor's office can also request records with your authorization.

Health • 18 min read

Getting a Second Opinion: When and How to Seek Another Medical Perspective

Understanding when a second opinion can help and how to navigate the process effectively.

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare providers for diagnosis and treatment decisions. Every individual's health situation is unique.

Key Takeaways

✓Second opinions are a normal, expected part of healthcare
✓Most insurance including Medicare covers second opinions
✓Consider seeking specialists at major medical centers for complex cases
✓Gather all medical records and test results before the consultation
✓Differing opinions may require a third opinion or careful weighing of options

When your parent receives a serious diagnosis or is told they need major surgery, seeking a second opinion isn't a sign of distrust—it's good medicine. Studies show that second opinions change the diagnosis or recommended treatment in 10-62% of cases, depending on the condition. For your parent's health and your peace of mind, understanding when and how to seek another perspective is an essential caregiving skill.

When to Seek a Second Opinion

Not every medical situation requires a second opinion, but several circumstances warrant seeking additional perspective.

Strongly Consider a Second Opinion When:

Serious Diagnoses

• Cancer diagnosis
• Heart disease requiring intervention
• Neurological conditions
• Autoimmune diseases
• Any life-threatening condition

Major Treatment Decisions

• Major surgery recommended
• Organ removal
• Joint replacement
• Chemotherapy or radiation
• Long-term medication regimens

Uncertain Situations

• Unclear or difficult diagnosis
• Treatment isn't working as expected
• Multiple health issues interacting
• Told "nothing more can be done"
• Symptoms don't match diagnosis

Quality of Care Concerns

• Doctor seems rushed or dismissive
• Diagnosis made without thorough testing
• Different options weren't discussed
• You have doubts or unanswered questions
• Trust has broken down

When Second Opinions Are Required

Some insurance plans require second opinions before approving certain surgeries or treatments. Check with your insurance about requirements for the specific procedure being recommended.

When a Second Opinion May Be Less Necessary

Clear-cut diagnoses (broken bone with obvious X-ray)
Standard treatments with well-established protocols
Minor procedures with minimal risk
Emergencies requiring immediate treatment
When you fully understand and trust the recommendation

Finding a Doctor for a Second Opinion

Where you seek your second opinion matters. The goal is to find a qualified expert who can provide an independent assessment.

Options for Second Opinions

Major Academic Medical Centers

Facilities like Mayo Clinic, Cleveland Clinic, Johns Hopkins, and university hospitals often have the most experience with complex or rare conditions.

+ Access to latest research and treatments
+ Specialists in rare conditions
+ Multidisciplinary teams
- May require travel
- Longer wait times

Local Specialists

Another specialist in your area who isn't affiliated with the first doctor's practice.

+ Convenient and accessible
+ Familiar with local resources
+ Could become treating physician if you switch
- May have similar training/perspective as first doctor

Remote/Telemedicine Second Opinions

Many major medical centers now offer second opinions via telemedicine, reviewing records and providing consultation remotely.

+ Access to top experts without travel
+ Often faster than in-person appointments
+ Good for initial assessment
- Physical exam not possible
- May recommend in-person follow-up

Finding the Right Doctor

Ask your current doctor: Many are happy to recommend colleagues for second opinions
Check with insurance: Ask for a list of covered specialists
Research credentials: Look for board certification and experience with your specific condition
Look for volume: Doctors who treat many patients with your condition tend to have better outcomes
Check hospital quality: Choose doctors affiliated with high-quality hospitals
Use disease-specific organizations: Cancer societies, heart associations, etc. often maintain referral lists

Tip: Seek Independence

For a truly independent opinion, seek a doctor at a different hospital or health system than your first doctor. Colleagues in the same system may be influenced by institutional practices or professional relationships.

Preparing for the Second Opinion

Thorough preparation ensures the second doctor has everything needed to provide a meaningful assessment.

Gather Medical Records

Records to Request

☐ Doctor's notes from relevant appointments
☐ Lab test results
☐ Pathology reports (for biopsies)
☐ Imaging studies (X-rays, CT, MRI on CD)
☐ Surgical reports if applicable
☐ Hospital discharge summaries
☐ Current medication list
☐ Complete medical history

Steps to Obtain Records

Request from each provider: Contact medical records departments
Sign release forms: HIPAA requires written authorization
Allow time: Requests can take days to weeks
Check patient portal: Many records available online immediately
Ask second opinion office: They may request records directly with your authorization
Bring copies: Don't send originals; keep a set for yourself

For Cancer Second Opinions: Pathology Review

If your parent has cancer, the second opinion doctor may want their own pathologists to review the biopsy slides. Request that slides (not just reports) be sent to the second opinion center. This "pathology second opinion" can sometimes change the diagnosis or staging.

Prepare Your Questions

Questions to Ask

1. Do you agree with the diagnosis?
2. Would you recommend any additional testing?
3. What treatment do you recommend and why?
4. How does this differ from what was recommended before?
5. What are all the treatment options?
6. What are the risks and benefits of each option?
7. What is your experience treating this condition?
8. Are there clinical trials we should consider?
9. What would you recommend for your own family member?

Insurance and Coverage

Medicare Coverage

Medicare Part B generally covers second opinions and even third opinions if the first two differ. Medicare considers second opinions a standard part of medical care, especially for surgical decisions.

Private Insurance

Most plans cover second opinions as a standard benefit
Some plans require second opinions before certain procedures
In-network doctors will have lower out-of-pocket costs
Out-of-network opinions may still be covered at a higher cost share
Pre-authorization may be required

Before Scheduling, Call Your Insurance

• Is a second opinion covered for this condition?
• Do I need pre-authorization?
• Is the doctor I'm considering in-network?
• What will my out-of-pocket cost be?
• Are remote/telemedicine second opinions covered?

If Insurance Doesn't Cover

If insurance coverage is limited:

Ask about payment plans
Some academic centers offer reduced fees for second opinions
Remote consultations may cost less than in-person
Consider the cost relative to the stakes of the decision
Some disease-specific nonprofits offer financial assistance

What to Do With the Results

If the Second Opinion Agrees

Agreement provides confidence that you're on the right track. You can proceed with the original recommendation knowing it's been validated by an independent expert.

If the Second Opinion Differs

Differing opinions are more common than you might expect. Here's how to handle them:

Understand the differences

Ask each doctor to explain their reasoning. What evidence supports their recommendation? Why do they disagree with the other approach?

Consider expertise

Which doctor has more experience with this specific condition? Are they at a center that specializes in this type of case?

Weigh the options

Consider risks, benefits, your parent's preferences, quality of life implications, and practical factors for each approach.

Consider a third opinion

When two experts disagree significantly, a third opinion from yet another specialist (ideally at a major medical center) may provide clarity.

Make a decision

Ultimately, you and your parent must decide. There may not be one "right" answer—just the best choice given all the information available.

Choosing a Treating Doctor

After getting a second opinion, you can:

Return to your original doctor for treatment
Have the second opinion doctor treat your parent
Find a third doctor based on what you've learned

Communicating with Your Original Doctor

Before Seeking a Second Opinion

You're not required to tell your doctor you're seeking a second opinion, but there are benefits to being open:

They can help facilitate records transfer
They may recommend specialists they respect
It maintains a collaborative relationship
Good doctors welcome second opinions

How to Tell Your Doctor

"This is a significant decision, and I want to feel completely confident. I'd like to get a second opinion before we proceed. Can you recommend anyone, and can your office help me get my records together?"

After the Second Opinion

Share the second opinion results with your original doctor:

They should know what another expert thinks
They can respond to different recommendations
If opinions differ, they may be willing to discuss with the other doctor
If you continue with them, they need this information in your record