2nd Opinion

Ask A Neurosurgeon.

Straight answers to the burning questions that patients would like to ask. One of our most viewed videos answers the questions:

The Question

Dr. McLaughlin, I've been told that I need surgery, and I'm thinking about getting a second opinion. Is that a good thing or a bad thing? I don't want to insult the doctor I've been seeing, but this seems like a big decision. How do you feel about second opinions?

The Answer

That's a great question. Second opinions in medicine—and I happen to have an opinion on this—are important, relevant, and helpful. I encourage all my patients to seek second opinions when I'm recommending surgery, and even when I'm not recommending surgery, because I want them to feel that their disease or problem has been fully analyzed.

If I'm providing an opinion about surgery, one of the first things I say is, "Listen, if this isn't an emergency and is an elective procedure, I encourage you to seek a second opinion." Some people ask whether they should go to someone in my group or outside of it. I generally recommend going outside the group and even outside the specialty, if possible. For example, as a neurosurgeon recommending spine surgery, I typically suggest seeing an orthopedic spine surgeon to get an opinion from someone with a different training perspective. You might hear a slightly different answer—not strongly opposed, but perhaps a nuanced variation.

It’s important to remember that there’s more than one way to treat a surgical condition. Some physicians prefer an anterior (front) approach, while others favor a posterior (back) approach. In some cases, the outcomes of both approaches are equivalent, and the choice comes down to surgeon preference. I fully encourage patients to get a second opinion, and I think you should be wary of a doctor who is uncomfortable with this idea. That might suggest they’re not fully secure in their recommendation.

Patients should also understand that hearing a different perspective doesn’t necessarily mean the first doctor was wrong. There are often multiple valid ways to treat spinal disease.

When I’m the one providing the second opinion, I take a particular approach. I tell the patient, “Don’t tell me what the first doctor said. I don’t want to know their diagnosis or treatment plan.” I start with the patient’s symptoms and provide a completely unbiased opinion. This approach reassures patients and ensures my recommendations are independent.

When I offer my opinion, two scenarios usually occur: either my assessment aligns with the first doctor, reassuring the patient, or it differs. If I believe surgery isn’t necessary when another doctor recommended it, for instance, I suggest seeking a third opinion to break the tie. Ultimately, patients should choose the doctor they trust the most—the one who gives them the best vibe and comfort level.

If you’re seeking a second opinion, what should you do beforehand?

1.     Research the doctor. If you’re looking for a surgical opinion, make sure the doctor is a surgeon, not a pain management specialist, anesthesiologist, or physiatrist. While these professionals can provide qualified opinions on medical conditions, they may not be equipped to provide a fully informed opinion about surgery.
2.     Check credentials. Look into where the doctor trained. Some programs are stronger than others. See if they completed a fellowship in spine surgery. In my opinion, a fellowship provides an extra level of expertise, as it adds a year of focused training in spine surgery.
3.     Ask questions. Find out how many times the surgeon has performed the procedure. Ask if you can speak to a patient who has undergone the same surgery. If possible, try to talk to a nurse at the hospital where the doctor works. Nurses often know who the best surgeons are.

Finally, be cautious of any doctor who discourages you from getting a second opinion. That’s a red flag. Second opinions are a vital part of making informed decisions about your health.

 

 

 

Disclaimer:

The video is presented for informational and educational purposes. It is not intended as a substitute for medical professional help, advice, diagnosis, treatment or hands on training experience. Always seek the advice of your physician and other qualified health providers with any questions you may have regarding a medical condition.

Dr. McLaughlin and ALL participants are not providing healthcare services through the use of this Website. Watching the video on the Website does not constitute establishment of a physician-patient or clinical relationship with any individual, nor establishment or offer to enter into a business relationship with any medical professional, institution or organization.

Dr. McLaughlin and participants disclaim any and all liability to any party for any direct, indirect, implied, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of the Video Content, which is provided as is, and without warranties.