As a patient, if you aren't comfortable with what I tell you, getting confirmation from a second doctor is definitely a good idea. Even still, these are words that no doctor wants to hear. Whenever patients say this to me, I always say that I'm not offended, and that a second opinion is their right. I know this is true. I really do. But on the inside, I'm fuming. I'm very good at what I do, but it's as if you're telling me that you don't believe me, don't trust me, or just don't like me.
My patient was a relatively young pediatrician who had severe acute-onset abdominal pain, and her internist thought she may need emergent surgery. I examined her thoroughly and reviewed her CT scan, but it looked to me like she had an acute flare of Crohn's disease. This is NOT a diagnosis I like to make, because it's a terrible, incurable, lifelong disease with potentially horrible complications. After my examination, I excused myself to chat with her internist and gastroenterologist who had been seeing her. I discussed the case with them, and they both agreed that this was the most likely diagnosis. Surgery during an acute flare of Crohn's disease is a terrible idea and is almost never necessary. A course of steroids usually calms the flare. I went back and sat with the patient to discuss the situation. She listened intently, thought for a moment, and said that she wanted a second opinion from another surgeon.
This was a particularly difficult case, and I explained that if she wasn't completely comfortable with my plan of care a second opinion is always fine. Oh no, she said, it wasn't the plan that she wasn't ok with. She just thought I looked young and wanted someone a bit older.
Really? REALLY? She's also a doctor, and she knew that my assessment was correct. I wanted to yell at her and tell her I've been a doctor for over a decade and I know exactly what the fuck I'm talking about. But fortunately I kept my composure and told her that was no problem. I know I have a young face and I get this sort of thing a lot, I told her with an apparently-boyish smile. A colorectal surgeon was called in as the second opinion.
He's two years younger than I am, but thankfully his hair is starting to grey.
The colorectal consultant completely agreed with my assessment, and the steroids were started. The next morning she felt 90% better. Surgery was avoided, and I felt completely vindicated.
I love being right, especially in situations like this. Maybe I should dye my hair grey so I look more venerable and believable.
EDIT: The patient sent me an email last night with an update:
There is something very satisfying about getting a "thank you" from a patient. It somehow makes the world seem brighter.I just write to thank you for your care. You were the only doctor, in my honest opinion, who truly cared and helped me during my stay. I underwent extensive diagnostics, and the biopsies are still pending. I went home off steroids which were stopped after 48 hrs.Thank you for your care and excellent bedside manners.