It might seem a bit sneaky, but it isn't in the least. Asking for a second opinion may not be a legal right but most doctors will be happy to help you get one. There are many good reasons why you might want to see another doctor.
"Sometimes people can get frustrated because it can take longer for their doctor to work out what is going on than they expected," says Professor Steve Field, a GP and chairman of the Royal College of General Practitioners. "People can lose faith in their specialist – they may feel they are being pushed towards an operation before they are ready. Or sometimes they feel as if their specialist is not dealing with them as if they were a whole person."
Doctor-patient relationships can also break down, says Field, because people have different expectations about how decisions are made. "Some people want a sharing relationship with their doctor in which [the patient] makes the decisions, and others want more direction and will complain if their doctor doesn't make his mind up about what the best thing to do is."
Ann Robinson, a London GP, believes that people want second opinions either because they don't like the doctor they've seen, don't like what they've been told or have more than one treatment option and need help deciding which to pursue. "If you can't talk to your doctor it's not unreasonable to request another one," she says. "Likewise, if you have been given a life-changing diagnosis you may want to make sure your doctor is right."
You can change your GP simply by finding another one in your area. But if you want a second opinion from a different consultant you need to ask your GP. What happens next "depends on the alternatives," explains Field. "You may need to be referred to another hospital. But your GP can also ask your consultant for clarification. Patients usually remember only 10% of what they are told and their GP can help them to navigate through what is happening to them." Specialists should write to the patient and send a copy to their GP, which helps open the channels of communication, but also, says Field, "patients need to develop partnerships with their GPs so they can talk about what they want."
If you do need to see a second specialist, ask your GP who they would recommend. You can also search yourself on Google Scholar (scholar.google.co.uk) to see who has published research in a field relevant to your case.
You don't have to tell a consultant who has been treating you if you're going to see someone else, but you may want to in order to copy your notes and test results to take with you. When you go for your second opinion, think about what you want to know, write it down and take someone with you as a prompt. "But don't cancel any appointments with your old consultant before you get your second opinion," warns Robinson, "just in case you like them even less than the first doctor you saw."
At the charity Breast Cancer Care, it's not unusual for concerned women to phone for reassurance that they're being offered the best treatment. "These days people have access to the internet and they can find out about treatment options," says Carolyn Rogers, clinical nurse specialist. "But sometimes what's online can be open to misinterpretation. Someone can read about a new treatment and we have to explain that it hasn't been through research trials and it isn't available yet in clinical practice.
"Women sometimes don't feel confident in what they have been told by the team looking after them," Rogers continues.
"They may not understand or like how decisions have been made or they might want confirmation or reassurance. Or it may just be about someone feeling more comfortable with a different personality. We're always supportive of people who want a second opinion."
In reality, though, there is sometimes little difference between the treatments offered to patients by different doctors. "This is especially true for women with breast cancer because so much of the treatment is standardised throughout the UK," says Rogers. "What patients may not realise is that it won't be just one doctor who makes a decision about the best treatment for them, but a multidisciplinary team with radiologists, pathologists and other doctors. It isn't just one opinion. Sometimes going to another specialist for a second opinion can create more anxiety and stress."
Field, however, believes that seeking a second opinion, and a culture of openness, should improve patient care. "Doctors shouldn't feel that it's a failure for patients to ask to see someone else. After all, it's the patient's illness, not the doctor's."