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There was a time when the doctor's diagnosis and "orders" were taken as absolute. Now people are far more likely to seek a second opinion. A recent medical study suggests that is a good thing.
The overwhelming majority of people who seek medical help do not have access to a program like the one provided by Best Doctors, Inc. Most of us have to get our second opinions with a certain amount of stealth and at least a modicum of tact, to avoid offending the doctors on whom we depend. There are worse and better ways to go about getting a second opinion as to your diagnosis and treatment when you want to maintain a relationship with a doctor you generally trust.

- Online medical information. There are some superb online medical sites, SteadyHealth, for example. The best sites take a great deal of care to provide accurate and actionable information, and never, ever pretend to substitute for a face to face examination from a doctor. The best medical information sites are certified with HonCode labels that indicate a genuine effort has been made to provide scientifically grounded, factual information that helps rather than hinders your efforts to get well.
- Online medical doctors. Websites like Zoc Doc, Doctors Lounge, Ask the Doctor, and Ask a Doctor Today promise answers to your medical questions in just minutes. The notion that you can get a "world class doctor" to answer your particular question right now for no charge is, well, ludicrous, but some sites offer useful information. Think of these sites more as sources of questions than of answers. They are great for finding the right questions to ask you doctor or doctors to fine-tune your diagnosis, but they cannot provide you with prescriptions or treatment, or with a diagnosis you can really trust. The only way you can get a legitimate diagnosis is to be seen in person by a licensed health practitioner.
- Appointments with doctors you schedule for yourself. If you have to pay for your medical care in cash, at least you have the ability to see any doctor who is willing to see you. If you have medical insurance in the United States, a "PPO" (preferred provider organization) usually allows you to see the specialists you like and to make your own appointments with prior approval, while a "HMO" (health maintenance organization) usually requires to get referrals through your primary care provider. If you know you have complex medical issues and you will have to see specialists on a regular basis, it is probably a good idea to choose a PPO over an HMO during your open season for registering for health insurance. The monthly premiums for PPO coverage are higher than those for HMO coverage, but it can be worth the added expense if you can possibly afford it.
What if you are stuck in an HMO? The best thing you can do is to persist in presenting your symptoms to your doctor. Don't make up symptoms, but take notes between visits so you can present your doctor with a written record of what is going on with you.
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Remember, doctors are only human. They make mistakes, too. A doctor who takes a little more time to give you a diagnosis could be exactly the doctor you want for long-term care. Be calm, be polite, be supportive, but persist until you get the diagnosis and treatment you need.
- Meyer AN, Singh H, Graber ML. Evaluation of Outcomes from a National Patient-Initiated Second-Opinion Program. Am J Med. 2015 Apr 23. pii: S0002-9343(15)00369-1. doi: 10.1016/j.amjmed.2015.04.020. [Epub ahead of print].
- Photo courtesy of francisco_osorio via Flickr: www.flickr.com/photos/francisco_osorio/8228710532
- Photo courtesy of KimSanDiego via Flickr: www.flickr.com/photos/kimsandiego/8168063548