Second Opinions 101

A second opinion should preferably be from a doctor who fits the following criteria

• Is board certified.
• Specializes in your diagnosis and its treatment.
• Has at least as much experience in the condition as your doctor - and preferably more. The more experience the doctor has, the greater the probability of a correct diagnosis and treatment course Board Certification by the American Board of Medical Specialists, in a field directly related to your condition, is a good starting point.
• Is independent of the doctor who gave the first opinion. Two doctors who are friends or work together are less likely to contradict or "second guess" each other. This may even be the case for two doctors in the same managed care insurance network or doctors who work in the same hospital or treatment facility. This is due to "institutional cultures." Institutional cultures are real, and occur when a respected physician or opinion leader recommends or provides treatment in a given way. Many others at the institution will often conform to the same point of view. At another treatment facility they may have a very different treatment philosophy. (If you have to see a doctor who is not independent of the first doctor, tell the doctor's receptionist when you call for the appointment that you want a truly independent opinion and for the receptionist to confirm with the doctor whether he or she can provide one. You can repeat your need when you see the doctor and judge for yourself whether the opinion will be independent. If it's not, go for a third opinion.)

Check to see if the doctor has been subject to disciplinary action. 

There is no one source to find out if a doctor has been disciplined. In fact, disciplinary proceedings are not made public in all states. That said, consider the following resources:

• State Medical Board Directors  "Doc Board" provides information on disciplinary action taken against doctors. Not all states participate or are represented on this site, but it is a good start to find out if a doctor has been disciplined. www.docboard.org
• Federation of State Medical Boards  "Doc Info" is the gateway and federation headquarters for all state medical licensing boards. For a charge of $9.95, the site will provide a physician profile including information on disciplinary actions. www.fsmb.org
• Public Citizen "Questionable Doctors." This non-profit consumer research and advocacy organization was co-founded by Ralph Nader in 1971. For a charge of $20, Public Citizen will provide a list of doctors, by region, who have been disciplined (with explanation) by state medical boards, Medicare/Medicaid, the Food and Drug Administration, and the Drug Enforcement Agency. www.citizen.org

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