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Second Opinions, You, and Your Insurance: Getting It Right

Posted on the 19 December 2017 by Pacificprime @ThePacificPrime
Second opinions, you, and your insurance: Getting it right

If you're like us, you live in a world where time is the most precious resource around. We take care to fill every moment with our days to the point that we even plan out specific windows with which to relax, and then we're right back to the grind. Perhaps because of this, getting injured or sick is more of a distressing event now than ever before.

The idea of visiting the doctor or hospital, or even worse, being bedridden for a period of days is enough to send us into full on freak out mode. If our timeline is thrown off, it can feel like our whole lives have been thrown for a loop, and yet, inevitably, we will get sick or injured at some point; most likely numerous times. We're not superheroes, after all, as much as we like to tell ourselves that we are.

Still, when we are put out of commission, so to speak, we nevertheless want to be able to get back to our thriving, dynamic selves as soon as possible. This is why the thought of being misdiagnosed by a trusted medical professional can be so off-putting, as well as why it can be so valuable to seek a second opinion when it comes to matters related to our health. However, many people never bother to seek a second opinion, sometimes to their own detriment.

Here, Pacific Prime discusses seeking second opinions, why it can be so valuable, and how second opinions relate to health insurance providers.

Why don't people get second opinions?

Are people really not seeking second opinions? Largely, the answer is no. Using the United States as an example, research has shown that anywhere between 50-70% of the American population never bothers to seek out a second opinion in medical matters, or even do independent research on their condition.

To be sure, not every condition or ailment that occurs will need a second opinion in order to get the correct diagnosis and treatment plan, so it is fine in many cases to not seek additional consultation. However, the more serious the issue, the more relevant it may be to get a second opinion. In these instances, there are many reasons that one is not sought, and here are just a few:

  • Confidence in a trusted medical professional: In countries and healthcare systems where family doctors are common, relationships can be formed with medical professionals over a lifetime. In these cases, a person may just trust their doctor so much that it would never dawn on them to seek advice elsewhere. Feelings of guilt or fear can even develop at the thought of seeing another doctor.
  • Belief in the authority of doctors: Even in the absence of a family doctor, some people simply feel the medical professionals must be right. After all, they're professional doctors, right? It should always be remembered that doctors are human beings that also make mistakes, and that two different medical professionals may diagnose and treat the same condition in different ways.
  • Time concerns: Many times people are in a hurry to address their medical problems, and want to get treatment underway immediately in order to get back to full health as quickly as possible. Patients should not be so hasty, though, as rushed medical care can result in a misdiagnosis that could lead to problematic or even disastrous health outcomes.
  • The doctors came recommended: Sometimes a patient may have a concern that, if they seek a second opinion, not only might they offend the doctor, but also the person who referred them to the doctor. However, when it comes to health matters, it's important that we don't let something like worrying about what someone else might think jeopardize our health.

Reasons to get second opinions

Having identified some of the reasons people may not seek a second opinion when they should, let's now look at the real benefits of getting a second opinion:

  • Ensuring the correct diagnosis: Again using the United States as an example, in 2012 it was shown that around 12 million Americans get misdiagnosed every year, and that anywhere from 5% to 28% to 40% of doctor visits featured diagnostic errors, misdiagnosis, or missed diagnosis. Even at the lower end of these figures, it's understandable why anyone would seek a second opinion to make sure that what a doctor tells them they have is what they actually have.
  • Avoiding risky treatment: The right diagnosis and treatment are critically important to patient care, and yet doctors will frequently vary greatly in how they feel they should approach treating a given condition. If you ever receive a treatment plan that involves a significant amount of risk to you, or that you are uncomfortable with for any reason, you should certainly seek out a second opinion and make your concerns known. There is a reasonable chance that another medical professional may have a course of treatment that carries less risk, or that addresses your concerns.
  • Treatment plans really do differ between doctors: It has been reported that, in cases where a second medical opinion is sought, only a low percentage of diagnoses may change, but up to 90% of treatment recommendations will differ from those of the first physician consulted.
  • Second opinions are easier to get than ever before: Are you familiar with telemedicine? Well, if not, it refers to medical consultations that are performed online via teleconferencing services like Skype. This practice is becoming more and more common, and it can allow you to get a second opinion right from your home with minimal time or effort expended. If you do end up getting a second opinion with telemedicine, just be sure that the consulting doctor has access to all of your relevant medical records, as they will not be able to perform any tests on you over an electronic device.
  • An improved bottom line: If you are an employer or have a business that provides health insurance plans for your employees, you would do well to make sure that medical second opinions are utilized regularly. This is because second opinions can oftentimes lead to surgical cost savings, resulting in group health insurance plan savings, as well as other long term benefits, including improved productivity, and reduced absenteeism and disability claims due to prolonged recovery times.
  • Peace of mind: Just think about it. If you get a single diagnosis and treatment plan, there may always be a modicum of doubt in the back of your mind that your doctor got it completely right. However, if you have a second, unaffiliated doctor confirm everything that the first doctor told you, that doubt will most likely vanish.

Second opinions and health insurance plans

Speaking of peace of mind, when talking about medical treatment, the only way to have full peace of mind is to make sure that you do not have to worry about the costs of treatment. Of course, the best way to ensure that such costs are covered is to have a private health insurance plan in place. How do health insurance plans interact with second opinions though?

To be clear here, most health insurance providers will provide coverage for second opinions. This is due to the fact that it oftentimes makes good financial sense for the insurer, in addition to the improved health outcomes for a policyholder that can come with a second opinion. In fact, due to the real benefits inherent to second opinions, some health insurance providers or plans will make obtaining a second opinion mandatory in certain situations. Situations where this will apply mostly involve major surgical procedures or other expensive treatments.

If you have any questions about your health insurance plan and how second opinions fit into it, contact the helpful insurance experts at Pacific Prime today! They are available to give you answers, and even have a look at your current policy to let you know the finer points of what it will and will not cover. They can also compare it to other plans on the market and give you free quotes if you find one that is more appropriate for your medical needs.


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