Getting a second opinion in Vet Med

Getting a Second Opinion

What do you do when faced with a disheartening diagnosis or expensive treatment option in the vet office?  When ‘Fluffy’ is sick and you are told, “there is nothing that can be done”, “the only option is very expensive”, or “I’m not sure what we are dealing with”, what can you do?  What would you do if this was your child, mother, sister or self sitting there in the doctor’s office?

Well, hopefully you ask questions, absorb answers, and then…take a step back. 

Questions you should be asking yourself:  Is this the correct diagnosis?  Are there any other possibilities?  Could it be something else? Do other options exist?  What does the latest research say?  How knowledgeable is this general practitioner or family doctor about this particular disease or problem? 

Doctors and Vets are like everyone else.  No one knows it all.  Everyone is wrong sometimes.  In vet medicine, as in human medicine, there are ‘specialists’.  Doctors, who somewhere along the way in their training decided, “Dang, this is a lot of stuff to know and keep up on”.  And so, decided to focus on one discipline or another, and become proficient in that discipline, so that it is possible to know almost all there is to know about one thing, or at least to know more about that thing than most others.  One discipline is possible to keep up with…all the disciplines?  Not so much.

Should you get another opinion?  How do you get another opinion?  Will you offend your vet by getting another opinion?  Ask yourself this.  If your vet took their child to the doctor and was faced with the same scenario, might they also be considering seeking another opinion?  Of course they would.  And quite frankly, if your vet, or family doctor, has your best interest in mind, which they are paid to do, then they should encourage a second opinion if it is something you feel you need, or they are just not sure they have the best solution or answer.  Of course it is human nature to become ‘defensive’ when our opinions or recommendations are challenged.  A character flaw graciously passed along to us through generations of imperfect parenting…but get over it!  Both of you!  Don’t be afraid to ask for something you are entitled to.  And Dr. Herriot, don’t get defensive when asked.  If you are so certain you are right, you will be rewarded when your client returns to you thanking you for encouraging them to find ‘their truth’…which hopefully happens to also be what you told them to begin with.  I guess if you do absolutely know it all, then and only then do you have some right to be defensive.

I am a specialist, and in my discipline, I know that certain problems have multiple solutions.  Although that is frustrating it comes from the acknowledgement that some problems don’t have a perfect solution; one that works as expected 100% of the time.  When faced with such clinical problems, I try to educate my client as to the nature of the problem, solution options, my recommendations…and if you are not comfortable with that, here is the name of another fella who I think does a good job with this problem.  Ultimately I want my client to be comfortable with the solution offered, because I realize the costs, the risks, and most importantly, that this ‘dog’ or ‘cat’ is a family member to you, and sometimes more.

So here’s what I suggest you do, prioritized in this order:

1.     “Doc, I love you to pieces and respect what you are telling me, and am grateful for it, but this is a big and difficult decision for me, and I need to do my homework educating myself a bit more.  I am sure you understand where I am coming from.  Can you recommend a way for me to learn more about this before I make a decision?”

2.     Ask your Doc if there is a specialist in your region whom you might consult with for a problem like this.  Not necessarily someone you will rush off that moment to see…but someone to consider.  Do they exist in your region?  What are the pros and cons of going for a referral?

3.     The internet.  The number one search topic on the internet is questions of health, and there is an abundance of veterinary health related information out there. Some of the information is really bad, and some of it really good—it is not always easy to find or understand, and may not be applicable to your pet’s situation, but if you are patient and have time, you can educate yourself.  Please consider the source of the information you are reading.  Is the source credible? Is it opinion, or, backed with science?  Are they well organized studies? Are there biases?

4.     Ask a friend or family for referral to another general practice veterinarian in whom they have faith.

Remember:

-Visiting another vet for the same problem will cost money; they are seeing you for the first time. 

-Bring any applicable records with you to the new appointment.  Your vet should not be reluctant (and legally cannot withhold them) to provide you with those records if you have discussed getting another opinion with them in a respectful and courteous manner.