When Should I Get a “Second Opinion” for My Hysterectomy or Other Gynecologic Surgery?

Occasionally, one has a gynecologic problem for which surgery is recommended. While at first glance this may appear to be the best solution to the problem, you may feel “uneasy” about it. How can you be sure that you are making the right decision? How do you know that you have been presented with all of your treatment options along with a realistic understanding of the chances for success in your personal situation? While consulting family and friends or searching the Internet may provide further insights, none of these will enhance your understanding and insights like a consultation with an experienced surgeon for a “Second Opinion.”

The value of a well-considered and complete second opinion is magnified in the setting of the current, fast paced, corporate “business model” of medicine so frequently administered today. When the physician/surgeon’s contact with the patient is less than 15 minutes, with much of that time spent doing “paper work,” how much understanding can the patient achieve prior to making the critical decision of proceeding with a surgical procedure? When was the last time a patient, in this atmosphere, had a complete, unbiased review of her records that were the basis for the recommended surgery. And when were alternative therapies clearly presented in the light of the personal clinical facts that led to the recommendation of surgery? Did the conversation include a thorough discussion of the chances of success with the surgical procedure and the inherent risks of the procedure? Were all of the other possible treatment choices presented?

A knowledgeable and thorough second opinion given in an unhurried and relaxed atmosphere permits surgical indications to be discussed and questions answered. This can go a long way towards allaying anxieties and assuring confidence that the proposed surgery is in the patient’s best interest. If the proposed surgery is the best choice. This should become obvious as the discussion unfolds. Alternatively, other less invasive surgical procedures that were never fully discussed by the original physician/surgeon may come to light at this time. Not infrequently, even nonsurgical options that may be as or more effective than the proposed surgery can be considered.

A thorough second opinion, particularly if it includes a physical examination when indicated, also serves to significantly lessen the chances of a misdiagnosis. Surgery performed for the wrong indication has a very low probability of solving a clinical problem.

A thorough second opinion will require all of your records that were part of the decision-making process leading to recommending the surgery. Based on these records and your history, the consulting physician/ surgeon may well want to perform a focused physical examination to confirm either their findings or his suspicions.

While this whole process will take 60 to 90 minutes, it may significantly change your life for years to come.

In looking for a physician to provide a second opinion for gynecologic surgery, find a physician who is well trained and experienced as both a diagnostician and surgeon with the independence of practice to provide the time, care and consideration that are required for an appropriate second opinion.

Gerald V. Burke, M.D.