Questions to Ask When Getting a Second Opinion
For a patient who has a diagnosis, or a recommendation for surgery or another treatment, and is taking it to a second doctor before agreeing, and for the relative who goes along. The list opens in the exam room, with what to ask about the diagnosis, the options and any gap between the two doctors, then turns to the errands around the visit: getting records and scans sent, talking to your first doctor, and checking what your insurer pays. Many of the later ones go to a scheduler, a records desk or a billing office, so they need not use up your minutes with the doctor.
The questions
Each question, and why to ask it
The diagnosis
Looking at my results yourself, do you reach the same diagnosis?
Why ask it
This is the question the visit exists for. Have the doctor say it in their own words instead of nodding at the letter you brought, and listen for any term that differs from what you were told.
How certain are you, and what else could this be?
Why ask it
A doctor who names the possibilities they ruled out, and how, has done the thinking in front of you. If one is still on the list, the follow-up is which test would take it off.
Is there anything in my file that you read differently from my first doctor?
Why ask it
Two doctors can agree on the name of a condition and still differ on the detail: the size, the extent, how far along it is. Have them point to the line or the image, and copy down the exact wording to take back.
Did your own radiologist or pathologist look at the images and samples, or did you work from the original reports?
Why ask it
Both happen, and they are not the same check. An opinion built on the first report carries along anything that report got wrong, so it is fair to know which kind you are getting.
Is a test missing that you would want before recommending anything?
Why ask it
Every added test costs days, so find out what each possible result would change. If the plan would be the same either way, say so and see whether the doctor still wants it.
How advanced or severe is it, in your reading?
Why ask it
Compare the word or the number with the one you were given before. When they differ, the useful follow-up is what in the results the new figure rests on.
Do any of my tests need repeating, and what is the reason?
Why ask it
The reason might be that the result is old, that the image quality was poor, or simply that this hospital prefers its own. Hear which it is before you agree, and check who pays for the repeat.
How often do you see this condition, and is it a main part of your practice?
Why ask it
A second look is worth most from someone who treats this week in, week out. If the condition is uncommon for them too, the follow-up is which colleague or center sees more of it, and whether your file could go there.
The options
If I had come to you first, what would you have recommended?
Why ask it
Phrased like this, you get the doctor's own plan and not a verdict on someone else's. It works best early, before you have described the first recommendation in detail.
Would you change anything about the treatment I was offered?
Why ask it
The change may be small: the timing, the technique, the order of two steps. Small changes are easy to carry back, and the first doctor may simply agree.
Is the treatment I was offered the usual one for this, or one of several accepted approaches?
Why ask it
Some conditions have one well-worn route and others have several that careful doctors choose between. Which kind yours is tells you how much to read into it if this doctor would go another way.
Which alternatives were left off the list I was given, including watching it for now?
Why ask it
Show the doctor what you were offered so they can see the gaps. An option may be missing because it was ruled out for a reason particular to you, or because the first hospital does not provide it, and you want to know which.
What would waiting a few weeks or months cost me, and does any option close if I wait?
Why ask it
Here you learn how much time the decision really allows. If waiting is cheap, you can think; if a choice disappears after a certain point, get that point as a date.
If we watch it for now, what would you check, and how often?
Why ask it
Watching is only a plan when it comes with a schedule and a trigger. Pin down which change in a scan, a blood result or a symptom would mean the waiting is over.
For someone my age and in my health, how do the risks of each option compare?
Why ask it
General risk figures describe an average patient who may not resemble you. Have the doctor say what about you moves each risk up or down, and write the options in two columns as they talk.
What result would you count as success, and how likely is it for me?
Why ask it
The same operation can be recommended with different hopes for it: full relief in one doctor's mind, a partial improvement in the other's. Put this answer beside what the first doctor told you to expect, because a gap in expectations is a disagreement too.
What would have to be different about me for you to recommend the other option?
Why ask it
Whatever the doctor names is the thing the recommendation hinges on: a test value, your age, how much the symptoms bother you. If the hinge turns out to be a preference of yours, the decision is more yours than theirs.
How would recovery and daily life differ between your plan and the first one?
Why ask it
Think weeks off work, help needed at home, driving, travel to appointments. When two plans are both medically sound, these are often what tips the choice.
Does it matter which hospital or team carries out the treatment?
Why ask it
For some treatments the answer is no, and for others the doctor will have a view. A good follow-up is what they would look into if they were choosing a place for someone in their own family.
Is there a newer treatment or a clinical trial I should know about?
Why ask it
What is available depends on where you live and where the doctor works. If a trial comes up, the first thing to learn is whether joining would delay the standard treatment or take it off the table.
Comparing the two
Why do you think my first doctor recommended something different?
Why ask it
A careful second doctor can explain the other view fairly. The gap often comes from specialty, training or what each hospital offers, and a reply that only dismisses the first doctor tells you little.
Do the two of you disagree about what I have, or only about what to do about it?
Why ask it
These are separate problems with separate fixes. A split over the diagnosis usually calls for more information, while a split over treatment may come down to what you value.
What piece of information would settle the difference?
Why ask it
It could be one more test, a fresh reading of the slides, or a few months of watching. If the doctor says nothing would settle it, put that to both of them: it may mean either plan is reasonable and the choice turns on what matters to you.
Would you be willing to talk to my first doctor directly?
Why ask it
Many doctors treat this as an ordinary call between colleagues, so it is less of a favor than it feels. Sort out whether you have to sign a release, who calls whom, and how you will hear what they concluded.
Can my case be discussed by a group of specialists, not one doctor alone?
Why ask it
Some hospitals bring difficult cases to a regular meeting of surgeons, physicians, radiologists and pathologists. Find out whether one exists for your condition and whether you would get its conclusion on paper.
Is a third opinion worth getting, and from what kind of specialist?
Why ask it
A third doctor of the same kind is just another vote. It helps most when the tie-breaker comes from a different specialty or sees this condition all the time, and when you can hand them one specific question to answer.
If both plans are reasonable, what should decide between them for me?
Why ask it
Before the doctor answers, tell them what weighs most with you: a quick recovery, the lowest risk, staying near home, being well for a date that matters. Their reply is only as good as what they know about your life.
Since you agree with my first doctor, is there anything I should still ask before I go ahead?
Why ask it
Agreement is a result, not a wasted trip, and you go ahead knowing the plan held up under a second look. Spend the minutes left on preparation and on anything the first visit left vague.
Will you send your opinion in writing to my first doctor, and may I have a copy?
Why ask it
A letter is something the first doctor can answer point by point, which your memory of a conversation is not. Get a rough date for it from the second doctor, and read your copy before the follow-up visit.
If I choose your plan, do you take over my care, or do I go back to my first doctor for it?
Why ask it
Some doctors who give second opinions only advise. If you would be moving, settle who tells the first office and how your records and prescriptions follow you.
Records and booking
Which records, scans and test results do you need from me before the appointment?
Why ask it
Put this to the second doctor's office on the call where you book. Some want the whole file and some only the recent tests, and whatever they list becomes your checklist for the calls to your first doctor's office.
Do you want the actual images and pathology slides, or are the written reports enough?
Why ask it
A report is one person's reading of a scan or a sample, while the images and slides let the new doctor do a reading of their own. If they want the originals, find out who requests them and how long that tends to take, since slides can be slow to travel.
Do you request my records yourselves, or do I collect them and bring them?
Why ask it
Either way, phone a few days ahead to confirm that everything arrived and can be opened. A disc that will not load on their system turns the visit into a second booking.
Will the doctor have read my file before I arrive, or will that happen in the room?
Why ask it
The answer tells you how to spend the first minutes. If the reading happens in front of you, hand over one page with the dates, the diagnosis as it was given to you, the tests done and the treatment proposed.
Do I need a referral from my current doctor to be seen here?
Why ask it
That depends on the clinic and on your insurer or health system, so check with both. If one is needed, requesting it is also a natural moment to tell your first doctor what you are doing.
How soon can I be seen, given that my treatment is already scheduled?
Why ask it
Give the scheduler the date of the surgery or the first treatment, because they can only weigh a deadline they have heard about. A cancellation list is worth getting onto if the first offer is too late.
How long is the appointment, and can I bring someone or record it?
Why ask it
A relative who writes things down leaves you free to listen. Recording rules differ from place to place, so get a yes before the phone comes out.
Can you review my records remotely, without my coming in?
Why ask it
Useful when the right specialist is far away. Check what you receive at the end, a written report or a call, and whether the doctor would have to examine you before saying anything firm.
Your first doctor
I would like another doctor to look at this before I decide. How do I get my file sent?
Why ask it
Say it to your first doctor in one sentence, with no apology attached. The practical answer usually comes from the front desk or the records department, which may need your signature on a release form.
Is there someone outside your own practice you would send me to?
Why ask it
An offered name is a sign that your first doctor is comfortable with the idea. You do not have to take the suggestion, and a doctor at a different hospital may bring a different habit of thinking.
How long can this decision safely wait while I get the second opinion?
Why ask it
Your first doctor's answer sets the deadline for booking. Put the same question to the second doctor later and see whether the two windows match.
Can I keep my surgery or treatment date while I do this, or do I lose it?
Why ask it
This one goes to the scheduler, not the doctor. If the slot cannot be held, find out how far ahead the next ones are being booked so you know what a pause really costs.
Can I come back and go through the second doctor's letter with you?
Why ask it
The return visit to the first doctor is where a disagreement gets a reply. Bring the letter, start with the points where the two differ, and notice whether the response deals with the reasoning or only repeats the plan.
Now that you have read the second opinion, would you change anything in your plan?
Why ask it
A doctor can adjust a plan without having been wrong, and a small change may be all the second look was for. If nothing changes, ask which of the second doctor's points was weighed and set aside, so you leave with a reason for each.
Insurance and cost
Does my plan pay for a second opinion, and does it ever require one?
Why ask it
Rules differ by insurer, plan and country, so put it to yours directly instead of assuming. Note the name of the person you spoke to and any reference number they give you.
Does the visit need approval in advance, and who asks for it?
Why ask it
Where approval is required, a missed step can leave the bill with you. Establish whether you, the first office or the second office files the request, and get the approval in writing before the day.
Is this doctor in my network, and what do I pay if not?
Why ask it
Check with the insurer as well as the clinic, and include the lab or imaging department that would handle any repeat tests. In a system without networks, the matching question is what changes if you go outside your area or see someone privately.
What will the consultation cost me, including any re-reading of scans or slides?
Why ask it
The review of images or pathology can be billed apart from the visit, sometimes by a different department. A written estimate from the billing office that covers both saves a surprise later.
If tests are repeated, will they be paid for a second time?
Why ask it
Raise it before the test is booked. The insurer may want the doctor's reason for the repeat on record, so see that it goes into the order.
If I decide to be treated by the second doctor, is that covered the same way as staying where I am?
Why ask it
Coverage for an opinion and coverage for treatment at the same place are not always alike. Find out before you settle on a plan, and count travel and time away from home if the second doctor is far off.
Making a second opinion worth the trip
Practical guidance for the conversation itself
Getting the file across
Start the requests the day you book
Records move slowly, and the second appointment is only as good as what has arrived by then. Call your first doctor's office, the imaging department and the lab on the same day you get the date, and note who you spoke to at each.
Reports, images and slides are three requests
The written report, the scan itself and the tissue sample are often held by different departments, and each may want its own request. Find out from the second office which of the three it wants, then ask for each one separately.
Write a one-page timeline
List the dates in order: first symptoms, each test, the diagnosis as it was worded, the treatment proposed and anything already tried. A doctor meeting you for the first time can take that in within a minute, and it keeps you from telling the story out of sequence.
Carry a spare set
Bring your own copies of the key reports, and the images on a disc or a portal login if you were given one. If the official transfer has failed, the visit can still go ahead on what is in your bag.
Using the second appointment
Say what you came for
Open with the purpose in one line: a fresh look at the diagnosis, a check on the recommended treatment, or a search for options nobody has mentioned. Each is a different job for the doctor, and they will spend the time differently once they know.
Hold back the first recommendation for a moment
If you can, let the new doctor read the results and say what they would do before you go through the first plan in detail. The file will already show much of it, but an opinion formed first is easier to compare than one given in reply.
Write down terms, not impressions
Copy the exact words used for the diagnosis, the stage or severity, and the name of any treatment. 'Roughly what the other doctor said' cannot be compared later, and two matching terms on paper can.
Split the work with whoever comes along
Agree beforehand that one of you asks and the other writes. The person writing should also keep the list and say which questions are still open when the doctor starts to wind up.
When the two answers do not match
Put both on one page
Draw two columns and fill in, for each doctor, the diagnosis, the recommended treatment, the reason given, the main risk and what they said about waiting. Laid out like that, it is usually plain whether they differ on one line or on all of them.
Name the kind of disagreement
A difference over what you have is a question of evidence, and more evidence may settle it. A difference over what to do can remain after every test is in, because it rests on how each doctor weighs risk against benefit, and on how you do.
Let each doctor answer the other
Take the second letter back to the first doctor and ask for a response to its specific points. If you are comfortable with it, ask the two to speak. You are not the messenger for a medical argument, and they can settle some of it faster without you in the middle.
Decide when to stop asking
More opinions do not always bring more clarity, and each one takes time that your condition may or may not have. Ask both doctors how long is reasonable, set yourself a date inside it, and make the choice with what you know by then.
Your first doctor and the bill
Tell them plainly and early
Say that the decision is a large one and you want it looked at twice before you commit. Telling the first doctor yourself keeps the relationship straightforward and tends to make the records request easier, since their office is usually the one that sends the file.
Keep your place in line
If a surgery or a start date is already booked, ask whether it can stand while you get the other view. Canceling first and asking afterward can mean a longer wait than the second opinion itself would have caused.
Make the money calls before the visit
Coverage, referrals, approvals and networks all depend on your plan, your country and sometimes your employer, and nobody at the clinic can answer for your insurer. One call to each, with the answers written down, is enough.
Ask for the opinion on paper
A written summary from the second doctor is what you will reread at home, show to the first doctor and send to an insurer that asks for it. Request it before you leave and find out how it will reach you.