Half of Americans don't get a second opinion

How to get the best advice
Provide your tests results and medical records. You may feel you'll get a fresher perspective if the second physician isn't aware of your first physician's opinion, but most experts don't think "blind" second opinions are a good idea. "It's harder to render a second opinion without knowing the basis of the first doctor's opinion," says Jonathan Schaffer, MD, an orthopedic surgeon and managing director of My Consult, the Cleveland Clinic's online medical second-opinion service.

Consider online second opinions — with caution. For starters, they don't involve face-to-face contact with a physician but rather a written diagnosis and recommended treatment plan. In some cases, if you have questions, you can speak by phone with a nurse assigned to your case — but not necessarily the doctor who evaluated your tests. Another drawback: Online second opinions — which range in price from $225 to about $750 — aren't always covered by insurance. The upside is that you receive the expertise of a top specialist without having to travel or take time off from work, which can ultimately be cost-efficient.

Be smart about conflicting advice. Your second doctor may contradict the first. If this happens, you can talk more with your first doctor about the differences or go to a third doctor — though be aware that your insurance might not pay for this. Another option: Log on to decisionaid.ohri.ca/decguide.html and access the worksheet used at Center for Shared Decision Making to counsel patients. Ultimately, in making these types of decisions, the thing to consider foremost is what you're trying to achieve, says Clay. "In life-and-death situations, some people want to live longer and some want to live better. It's quantity versus quality, and that's a very personal decision." In less serious cases, it can be a matter of weighing your current discomfort level against the risks involved with the available treatment options. The best choice, says Clay, "is the one that helps you reach more of your goals while allowing you to accept living with the good and bad consequences."

Find Dr. Right
When you need a second opinion, here's what you'll want to look for:

A doctor affiliated with a hospital other than your original one. Hospitals and practices can be set in their ways when it comes to treatments, says Gazelle. For example, some use tests even when there's insufficient research behind their efficacy simply because staff members have developed them. You want to be sure the recommended procedure is what's best for your unique medical situation.

A staff member at a big research and teaching hospital. This is especially important if your condition is rare (say, an unusual form of cancer) or complicated — for instance, you suffer from heart disease and have also been diagnosed with asthma. "These places attract physicians interested in learning new procedures and remaining on the cutting edge," says Rohack. Another advantage: Such centers will have a variety of specialists on staff who can contribute their expertise to your case.

A physician who's more experienced with your problem than the first doctor. This is the minimum you should do if your condition is more common — you've recently been diagnosed with diabetes or might need a hysterectomy. Ideally that means a board-certified specialist in the area of concern. To check on a doctor, log on to the American Board of Medical Specialties at abms.org, or call (866) 275-2267.

Get your first doctor on board
Telling your doctor you want to see someone else for a second opinion can be awkward, particularly if you've known him for years. But a good doctor won't be insulted and many will recommend it to you themselves, says Kate Clay, RN, program director at the Center for Shared Decision Making at the Dartmouth-Hitchcock Medical Center in Lebanon, NH. If they don't, here's what she suggests you say (or don't say) to your doc:

Say: "This is a difficult decision for me and I'd like to learn about other treatments than the one we discussed. Can you recommend someone I could talk to?"

Don't say: Any version of "I don't trust your judgment. I don't like you. I'm not sure if you're a good doctor." Comments like these would put anyone on the defensive.

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