Are you ever asked to give a second opinion in your Private Practice?
How does it make you feel when a patient arrives asking for a second opinion?
Do you feel concerned, flattered, or intrigued?
Second opinions are a big part of my own Private Practice, and they can be really useful way to boost your Private Practice work – if you go about it the right way.
Many patients are desperately seeking an answer to their problem, but second opinion requests have a funny way of making some Clinicians feel uncomfortable.
Has the patient seen every Tom, Dick and Harry in the land, and are therefore likely to be ‘trouble’?
Are they going to ask you to critique a colleague’s work (which could get awkward if you feel that your colleague didn’t do a brilliant job)?
Perhaps you’ve even had the experience whereby a patient has asked for your (valuable) second opinion, but they didn’t take your advice, and went with A.N.other’s anyway?
Second opinions can be a really satisfying experience for both you and your patient.
If you’re not readily promoting that you are happy to give second opinions, then patients may not seek your expertise out.
Many patients seek second opinions for very genuine reasons:
They want a ‘proper’ diagnosis or at least to confirm the diagnosis they have already been given makes sense.
They want to know that the treatment that has been suggested is the ‘best’ or the correct treatment for their particular situation.
They may be seeking some additional rubber stamping that they should push on ahead with the suggested plan.
They may be looking to see if there are further options that haven’t been disclosed to them.
They thought that the last Clinician’s treatment plan made great sense, but said Clinician’s sense of self-importance resembled that of Donald Trump’s.
As a Sports Doctor, I’m asked on a daily basis for a second opinion about whether or not I’d recommend that a patient goes ahead with a plan for surgery.
I believe it’s important not to become attached to the outcome of the second opinion.
In other words, the second opinion, is just that – a second opinion.
It should not be viewed as an opportunity ‘sway’ the patient to come over to your side, or to ‘poach’ the patient.
What’s the best way to go about giving a second opinion?
1. Set expectations.
There can be pitfalls for the patient during the second opinion process:
New diagnoses may muddy the water and leave them feeling even more confused about what to believe.
They may still get the bad news that they were hoping not to hear, (and now they get stung with it a second time).
Seeking further opinions can delay getting cracking with the actual treatment.
They may end up feeling torn as to whether to go with you next, rather than the clinician they originally saw.
2. Start afresh, and don’t take anything as gospel.
Often the patient will want to race ahead to tell you what Mr or Mrs ‘X’ said, so that they can ask you to reflect on previous opinions given. It’s really important to steer the patient back to the beginning.
Act from the stance point that you are the very first person to gather the patient’s history and to examine them.
Explain that you’re going to need to go over old ground, and if needs be, ask them to drop using medical terminology, and encourage them to use lay terms. Resist asking whom they have seen before, until the very end.
3. Make sure you have access to real images, not just reports.
Radiological reports are also ‘opinions’. Make sure you look at the raw data, and don’t rely on someone else’s interpretation.
If you need fresh imaging, or to repeat other investigations which may be out of date, explain why to the patient, and don’t settle for what can’t give you the whole picture.
4. Resist being judgmental about others’ clinical work.
Even you think the patient has been told a bunch of old codswallop.
Patients can sniff out rivalries a mile off and it will make you look less credible.
If the patient pushes you to line up your opinion with another’s, try to dispassionately unpack what has been said, and see if there might be any elements that you can agree with.
5. Go ahead and give your opinion!
This might seem obvious, but you’re no use to the patient if you don’t actually state what you think the problem is, or how you would recommend going about getting it sorted.
Remember it’s good to reinforce a line of treatment that’s been suggested if you think it’s a good idea – sometimes patients are just looking for the ‘go ahead’ signal.
However, be prepared to stick your neck on the line, and don’t be a sheep, even if everyone else has given a polar opposite opinion.
And finally, remember to thank the patient for coming to see you, and wish them well in their decision making.
Second opinions can be a great way to grow your Private Practice, so if you’re keen to give second opinions, make it known on your website, and in the content that your produce.
Looking for further ways to grow your Private Practice? Check out the Ninja Academy:
See you next time!