[Talk Host]

I actually posted this in a thread about glaucoma, but I don't want to hijack that thread with this question, so I am starting a new thread about it.

"Maybe someone can answer this for me. When you get a "second opinion" and it differs from the original opinion, which one do you believe? Do you now have to get a third opinion?

I recently had an opinion from a dermatologist that I need to use an unpleasant chemical cream on my face to destroy sun damaged skin. I got a second opinion from a dermatologist and he said that he saw nothing that would indicate that I needed the treatment. He said, in fact, that if he had used the treatment on me, he always prescribes one half of what the first guy uses.

First guy said to come back in 14 days so he can see the progress. The second guy said he prescribes it for 15 days and the patient doesn't have to come back until 5 months has passed.

First guy says the treatment can become really unpleasant and that it'll get worse before it gets better. Second guy said, if it gets unpleasant, "stop using it." Second guy said that it should get no worse than a bad sunburn.

I actually have opted to go with the first opinion and do the treatment twice a day as prescribed. (second guy said only once a day) I'm now in my 5th day of a 14 day treatment."

I look kind of like a pepperoni pizza.


JLK

[zcaveman]

When you asked about the efudex treatment I posted to you it would be hell but others disagreed. They made it sound like a walk in the park. I understand your plight and know what you are going through. Have hope, it will all be over soon.

I am going to a doctor for a problem. After a CT scan, a CT/PEP scan, and an MRI, they want to do something that I am not excited about so I asked about getting a second opinion. I was told by the doctor that I could but after the second doctor sees my scans they are going to recommend the same thing. The English version of the scans back him up.

He also said that there was a time when the insurance companies made you go for a second opinion (back in the 80s I think) and the insurance companies finally decided that the original doctor was usually right and it was costing them money so they stopped the requirement. I remember having to go for a couple of the second opinions and it cost the insurance company money and me a lot of lost work time.

I guess somewhere along the line you have to decide that the doctor knows what he is doing and that he has your best interest in his decision to do what he is doing.

Maybe I an just naive.

Z

[zcaveman]

It seems strange that no one has a position on second opinions.

[Pturner]

I guess it depends on the circumstance. If I were recommended for surgery that wasn't urgent, or if it were for a condition for which other treatment options were available, I'd probably want a second opinion. Same with an invasive or apparently terribly unpleasant treatment proposal, as TH described.

But TH brings up a good issue: what do you do when the second opinion disagrees. I'd do internet research. I'd probably seek out the experience of others (as TH has done). I'd consider how well the first doctor knew me and the relative faith and confidence I had in each doctor.

Then I'd shoot myself.

Oh, sorry. Not funny. Then I'd have to make a judgment call.

[Sherman931]

You can get a second opinion and a third opinion and etc.; but it will still boil down to the patient having to make the final decision.

[gage405]

Personally, I would not do that skin treatment unless the Dr. told me that
it was a cancerous spot that was to be treated.
I would have gone with the second opinion.

[gage405]

Basically, I am stating that I would go with the opinion that is the most
conservative one, whether it was the first or the second.
Sometimes Drs. are too aggressive with a treatment plan, imo.

[JeffBorn]

An answer that may be a little more focused than second opinions. Oddly enough I began the same treatment just under a week ago. My primary physician whom I have the utmost faith in told me I had sun damage not adult acne, just red spots on my forehead. He said that if I wanted to avoid having him remove precancerous spots on a regular basis the treatment would be a good choice. His directions were the same as your first opinion, twice daily, see him in two weeks, Possibly addtional two weeks of treatment. He showed me pictures of very red faced patients undergoing treatment, he described sometimes really unsightly temporary condition. It is essential to keep treatment area from sun (UV) for up to two months. The damaged spots will ulcerate and then heal. Expect things to get worse before they get better. I would go with opinion one and stay away from opinion two in this case.