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Just curious

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:23 AM in Back Surgery and Neck Surgery
For quite a while I have read over and over where members recommend to other members to "get a second opinion". Some even say "get a third or fourth opinion". I've even recommended that members seek another opinion in certain cases.

What I'm curious about though, is how do members who have no insurance or poor insurance, go out and get that other opinion?

It seems that when this advice is given, it is given without thought as to whether it is even possible or not. I know I haven't checked into how hard it is for someone to do that, when I have recommended it.

The intention is well founded, but is it causing more grief to the person being told, who has absolutely no way of getting to another doc let alone another opinion.

Just curious,



  • You r so right and it just does not seem fair....ladybug
  • I have thought about this also. Even with insurance it is often a difficult task to get another opinion, especially with HMO's. You are entitled to a second opionion, but there are many hoops to jump through. You have to get a new referral, have it authorized by the insurance, make an appointment (many times these specialists are booked out months in advance), so this task could take months to accomplish. I know I didn't get a second opinion as a am a nurse and I had thoroughly investigated all local neurosurgeons who take my insurance, and I was recommended to only go to my surgeon. The Neuroscience nurses at the hospy where I work and had my surgery told me NOT to let any of the others touch me at all. Kinda sad, but at least there was one good one left, mine :). I can imagine it is probably even more difficult for people with workmans comp, medi-cal/care, no insurance, or public health insurance in other countries to get that desired second opinion. I considered going to UCSF for another opinion, but in the end I really didn't want to commute for surgery (no one to drive me, unfortunately), so I stayed with my guy. I feel for all these peeps with lousy docs who aren't helping them. I am sure many of them are stuck. I hope they all get the answers they need and deserve. Sue
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  • Thanks Ladybug and Cali-Sue for your replies. Glad to know that I'm not the only one worried about this and how it might effect the thought process of the member being encouraged to get that next opinion.

    Is there anyone in one of these situations that would care to share how it made them feel and if they pursued it or not and how they went about it?

  • Like Cali-Sue mentioned, I belong to an HMO with over 200 doctors (or more?) between several clinics, so all I had to do was leave a message for my PCP to refer me for a second opinion. But my daughters had been without insurance at certain times of their lives, so I am very aware of how difficult it is for some people. On the other hand, I have a friend who is on permanent disability and is covered under Medi-Cal, and she seemed to be able to get referral when needed. People who don't have any coverage at all, I guess end up in the ER's. Not the best system, isn't it?

    But the advise to get a second opinion, if it is at all possible, is still a good one.

  • We all know that medical care is expensive. Those of us who have insurance are fortunate. So should members stop mentioning "second opinions?" I'm sure there are some cases where not getting a second opinion is very costly in a number of ways. In my opinion, there is more advice from SH members leaning towards mentioning how awful you will end up if you don't have surgery. Has anyone noticed this? I'm just wondering? One thing I have learned from folks on SH sharing experience is that surgery is not a cure all for everyone. ---Mazy
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  • Mazy said:
    In my opinion, there is more advice from SH members leaning towards mentioning how awful you will end up if you don't have surgery.
    I agree with you that this is as prevalent a theme these days. Good catch!

  • I think it is always wise to get a second opinion,but having said that I admit that I often don't follow my own advice.

    I distinctly remember talking with my first surgeon about getting another opinion and I know that he was not happy..it was proven when my new surgeon (office) requested all of my old films and they were denied.They asked me to go in and get them,telling me that they could not deny them to me.They most certainly did deny me,not only my films but all of my records from that office were gone.That surgeon performed 4 operations and everything was gone.So they said.

    I believe too sometimes that if we were to go to 100 Drs that we would probably get about 50 different opinions(roughly speaking)But yes,I think if at all possible get a second opinion.Of course we are not experts at much other than ourselves and speaking only for myself that is questionable..but I think too that we should follow our instincts.As with Drs we would have to rely on trust.

    I doubt it if too many people with no insurance get a second opinion.Maybe some do,and I'm certain it causes some people stress if they can't afford to get the care that they want/need.

    Most people are resiliant and learn to adapt to a certain lifestle.That does'nt mean that they like it,only that it is what becomes their normal.

    ..and I realize that makes me sound cold and uncaring,but that is not the case I assure you.
  • The situation in Ontario is different. Our primary health care costs are covered so IF you could get a 2nd opinion it wouldn't cost you anything. However the problem is that you can only see a specialist by referral. You can't just look up the name of a surgeon in the phone book, call and make an appointment. You have to go back to your primary care doctor and ask him to give you another referral. It's all up to him and he could refuse. I had done a bit of research before my doc had given me the referral. I knew that I would not accept going to a particular hospital or surgeon that I had already heard some bad things about (met one of his patients who had a very bad outcome). I was happy when he didn't refer me there because I would have said no. I was lucky my doc referred me to one of the best surgeons in Canada. We're not all that lucky. Sometimes we don't get the best doctor or the best advice. In that case, if you can afford it, it is better to get another opinion. However, I think sometimes SH people respond with "get a 2nd opinion" because it's better than giving a diagnosis because we can't.....and they just want to help.

  • I always say when in doubt or troubled with a diagnosis / treatment to get a second or more...... I really never have thought about clarifying the statement for capability to do that.....
  • I must say that my opinion is to ALWAYS seek out a second opinion. I completely understand the financial strain of things. Believe me, I have a $5,000 deductible with my private health insurance, and we support our family on what has become a VERY modest income since I am not working now. Shelling out an extra hundred dollars or more for a 2nd opinion hurts. But, when you consider the seriousness of spine surgery, how can anyone take it so lightly that they don't seek a 2nd opinion? And if those two opinions conflict and you still aren't certain, seek a third. Even if you have to make small payments to them, or put it on your credit card, or go beg from a relative, get a 2nd opinion.

    I have said this before, but spine surgery isn't like having your appendix out. They don't just go in and remove the problem, sew you up, and you are good to go. Most of us are never the same again after having spinal surgery. Not to say that we shouldn't have surgery, because I for one am thankful that surgery was an option.

    Many of you know my story. With my first surgery, I was set up to have a 2 level ACDF. however, after thinking about it for a period of time, and knowing that I also had a large herniation and stenosis at the third level, I made a phone call to my surgeon's office requesting that they add the third level to the scheduled surgery. I didn't even talk to the doctor about it, just his nurse. I thought "No big deal." Just get it done while they were in there so that I didn't require future surgery. WRONG!

    Obviously my surgeon didn't have any issues with doing a larger surgery. I honestly had no idea that the more levels you have worked on and the longer they are working on your spine, the greater your chances for complications. And the greater your chances for needing more work done in the future anyway. And the greater your chances for having a non-union. what I thought was "no big deal" actually was a huge deal, complete with the major complications, the non-union, and the necessity to have even more work done with the revision surgery.

    Now, I had a 2nd opinion, but it was prior to requesting that the third level be added. I 100% believe that if I had only had the two levels done, I would be in a different place than I am now. This situation completely illustrates why it is so important to get a 2nd or 3rd opinion. Had I asked the 2nd opinion doctor about having the third level done, he would have told me no. There was no nerve root impingement at that time, and the risks of having it done then far outweighed the risks of needing it done later.

    Sorry for the length of this post, but sometimes I feel like people here are almost excited to have surgery. Sometimes it seems that many feel that it is "no big deal" and that if the doctor says it needs to be done, it must need to be done.

    One more example. I have a little neighbor lady (around 65 years old). She has a problem with her low back right now, causing some tingling and numbness down her leg, but not really a lot of pain. She had a consultation with a surgeon and was told that surgery was a good option for her. She sought a second opinion, not at her request but at the request of her insurance. She chose the doctor (I actually recommended my 2nd surgeon, Dr. H, to her.) Her appointment was this week. Dr. H told her that he does not feel that surgery will help her. He feels that PT and injections should be tried first, and even after those have failed, the type of surgery she was looking at would not really help her with the numbness in her leg. She basically has DDD with no cord impingement, and little pain.

    So there you have it. Two very differing opinions. One patient who is functioning fine with very little pain, just worried about the numbness and tingling. One doctor ready to put her on the operating table, one telling her that surgery wouldn't really help her at this point. Which one would you believe? Do you think she should have jumped on that operating table and had the surgery without checking out her other options? I think not.

    Getting a 2nd opinion takes time and money. But isn't your health worth it? I would never ever ever recommend spine surgery without one first checking out all their options and knowing what they are getting into. If a doctor has an issue with you seeking a 2nd opinion, I would say run from that doctor as fast as you can, because he/she obviously doesn't have your best interest at heart. Most doctors will actually set you up with another surgeon for the 2nd opinion; and get you in much quicker than if you make the appointment on your own. Care about your health and your spine enough to make sure you are doing the right thing before you let anyone that close to your spinal cord.


    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
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