Navigating Second Opinions: You Have The Most At Stake | Navigating Now

I’ve worked hard all my life. I saved up enough money to pay cash for my brand-new BMW. A month after I buy it, the check engine light comes on. Where am I going to take my prized BMW? My first instinct might be the automotive shop a mile from my house, because I used to take my last car there; I know and trust the mechanic, and I can’t beat the convenience.

But my last car was American-made, not a German import. I know automotive shops often specialize in different makes of cars. So I might ask my local mechanic to diagnose the problem and give me a repair estimate; but I’d also get an estimate from a shop that knows BMWs inside and out. I want to be sure I put my new car in the right hands.

I don’t actually drive a BMW. I use this metaphor because getting the right fix for such a prized possession seems like a no-brainer. Why, then, would I treat my body and my health any differently? Why would I put my life in the hands of the first doctor I happened to get scheduled with?

Yet many patients do just that because they are reluctant to seek a second opinion. Here I want to talk about that reluctance and why it’s vital for patients to overcome it.

Before we do that, though, we have to understand the reasons why patients are reluctant to seek second opinions and examine whether those reasons serve a patient’s best interest.

Based on what we know from experience and hear from our community, there are four main reasons patients give for not seeking a second opinion:

  • Bedside manner: “My doctor is just so nice. I feel very comfortable with him.”
  • Brilliant doctors: “My doctor is the most brilliant woman I’ve ever met. She must know what’s right for me.”
  • Fear of offense. “I don’t want to offend my doctor.”
  • And perhaps the most common, fear of wasting time: “I can’t afford to delay my treatment.”

Let’s address each of these in turn.

Bedside Manner

First, the bedside manner factor. Receiving a cancer diagnosis is one of the most paralyzing and fear-inducing experiences anyone can have. Of course you want a doctor who makes you feel safe, comfortable and well-attended. Kindness and sympathy in a doctor should not be taken for granted. If those qualities are most important to you, it’s your right to be guided by them. But keep in mind that finding great bedside manner in one doctor doesn’t prevent you from seeking the opinion of another. Good doctors are open to collaborating with each other to make sure you receive the best care possible.

Brilliant Doctors

Next, there are many brilliant doctors. But they also happen to be human; no one doctor can know everything. Plus, there is the resource factor that I talked about last month: each doctor may not be able to keep abreast of all the variables in the rapidly evolving cancer landscape, and each doctor draws on her available resources and experience in treating patients. So no matter how brilliant your doctor may be, one should consider confirming her proposed treatment strategy with a second opinion than to discover later there was a more promising strategy available – or, worse yet, that you’re taking a drug that is not right for your case.

Fear of Offense

Third, the notion of “offending” your doctor by having someone else review your case is an interesting one. While, yes, it has the potential to be an awkward conversation, it shouldn’t. Here’s why: you are the paying customer. I know we don’t like to think about healthcare this way but it’s the truth. You pay your premiums or you pay out of pocket to be there in the doctor’s office and you have the most at stake. If your doctor is anything other than supportive of you getting a second opinion, then you need a new doctor. However, there is one critically important caveat: in some cases, it is medically necessary to begin treatment as soon as possible.

Fear of Wasting Time

That brings me to the fourth point, which is also the most difficult to address: the fear of wasting time. I watched my Dad make decisions, on two separate occasions, based on his belief that he needed something in his body to fight the cancer. As a caregiver, I don’t know what it’s like to have cancer present in my body and wrestle with those decisions. But as a caregiver, I can say the most important thing to me was for my Dad to get the best treatment for himself, not necessarily the first available treatment. So I advise you to ask your doctor: “Is it OK if I wait a few weeks so I can get a second opinion?” It can’t hurt to ask and only takes a few moments. The answer may be no; your cancer may be too advanced and/or too aggressive to put off treatment even for a few days. But if the answer is yes, please consider getting a qualified second opinion.

Let me sum up with two important messages

  • If getting a second opinion, or even third, would give you peace of mind, go get it! You must do what’s best for you.
  • It’s never too late to get a second opinion, whether you were just diagnosed yesterday or you’re on your second line of treatment.

The second step in SURVIVEiT’s Cancer Navigation Tool, is getting a qualified second opinion. We’ve done the research to identify which doctors are deemed “Best in Class”, making it as simple as possible for patients to quickly identify and schedule an appointment to get that qualified second opinion.


Joy Brewster Rusthoven
Executive Director