How do you get an independent and honest second medical opinion?

[kristina]

I have a few questions about second opinions and I wonder if anyone has had similar thoughts and if they have, how did they go about obtaining a completely independent second opinion? My idea of a second opinion is one which is completely and utterly unconnected with the original diagnosis. Like, for example, a garage tells you, you need a new engine and naturally you think this is odd. So you take your  car to another garage for a completely independent opinion. If the second garage wants to know the name of the garage who gave the original opinion wouldn’t you “smell a rat”, because if the two garages confer you don’t really know whether you are being set up or not.

My second-opinion-problem is this, that a hospital to which I would like to go for a second opinion asks me where I have gone for the original opinion.
Also, they require a history of blood-tests etc, which naturally is supplied by the original hospital I went to, so my second-opinion-hospital knows where I went originally and the names of the doctors I saw. So, I feel, their opinion would not be independent. Furthermore, this second opinion would cost me lots of money (which I haven’t got) and I am left unsure whether that second opinion would be thoroughly honest and independent. Of course, this may not happen with simple medical problems where one blood-test or x-ray decides the matter (I once had a second opinion on a bone-fracture which I was perfectly satisfied with, because all the hospital had to do was take another x-ray and give an opinion, which they did to my benefit), but in my case with MCTD/SLE with end-stage-renal-failure invariably the hospital needs many other tests (ultrasound of kidneys, heart and lung-tests, etc) in addition to many blood-tests. Also, it is important for the hospital to know my medical history in quite some detail and all this makes it very difficult for me to get a second opinion which I can thoroughly trust and rely on.  Because of my rare disease of MCTD/SLE I often felt in the past that hospitals/doctors only gather information on my disease for their own medical studies and that they are not genuinely interested in helping me medically to manage my disease. It is always an awkward situation when one is face to face with a doctor, asking for a second opinion, and that doctor enquiries what previous hospital I have been to, and by not answering this question I am made to feel as if I am uncooperative. But it would appear that they, lacking the confidence to deal with my medical situation, need the back-up of their colleagues-doctors of the hospital I originally went to. If anyone has any thoughts on this dilemma I would be extremely grateful to them. Thank you.



Edited: Fixed error in Subject Line - okarol/admin

[cat]

Kristina,  I can fully understand your feelings - I feel much the same way.  When I asked for a second opinion about my kidney failure, the first doctor the hospital sent was the partner of the original doctor!    

You are entitled to an objective second opinion.  Although you should provide whatever information is requested, I think you will get an impartial evaluation of your medical condition.  Your insurance should cover the cost of a second opinion.  I know that Medicare does - at least they did for me.

I would go ahead with a second opinion.  I am sure it will be objective.  I wish you all the best.   

[paris]

I did not care for the first nephrologist who diagnosed me.  He didn't have a course of action for me.  So, I asked the nurses in the office which doctor was known for researching and looking for new answers.  They all told me the same name.  I asked to meet him and I immediately trusted him.  That is what makes a huge difference, trust.  I wouldn't be were I am if I hadn't changed doctors.  Always keep asking questions.   

[Chris]

From my experience, when I go to a new doc for a second opinion, I don't tell them I went to another doctor already. That way they can do test they want to do and give a true independent opinion. With labs, however depends on your situation. Let's say you went to the ER as was told you have renal failure and are given a doc you do ot like.  You then go loking for a doc you may like, who then may ask why you have come here. You say you were in the ER and said you had low kidney function and you present lab work done on that ER visit and nothing else. He then will most likely order further test to eother confirm and plan the next stage of treatment, or find something new.

Sometimes you have to be inventive on how you approach things to get a true second opinion. Sometimes they do not need to know a thing, sometimes they may need to know what another doc thought. Depends how comfortable you are going about to get a second opinion.

[ddawson77]

I agree with Chris, if there is another city close to you I would look up a doctor there and not even tell them that you have already seen someone else. 

The first Neph I saw was great, but after a year they switched me to someone else, which ended up costing me a week in the hospial and the doc's there couldn't believe what he was doing. 

Just make sure you have confidence in your doc, the care you will recieve will be many times better.