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Second Opinion and Physical Therapy

If you find yourself in a hole stop digging.
Will Rogers

Decisions regarding healthcare can by very important. There are times and situations when getting a second opinion regarding healthcare advice are a prudent action. Studies have shown there are generally better results if you do get a second opinion.

A healthcare practitioner can recommend their patient should get a second opinion from another healthcare provider. The patient can request a second opinion from another healthcare provider.

Getting and providing second opinions regarding medical care is a common practice. Getting and providing second opinions from a Physical Therapist is a less common practice, but should not be. A Physical Therapist can provide information confirming or disagreeing with advice from the first healthcare provider. Be aware if your Primary Care Physician is of the opinion that Physical Therapy is not indicated for your problem you can still request and obtain a Physical Therapy evaluation without a Physicians referral. Not all Physical Therapy is the same. If you have seen a Physical Therapist for your problem without resolution it may be a different Physical Therapist can provide better care. If Physical Therapy is not indicated for your problem the ethical standards for Physical Therapist require the Physical Therapist to share that opinion.

Abraham Maslow a noted psychologist said “if the only tool you have is a hammer you tend to see every problem as a nail”. If you go to surgeon he will offer your surgery, if you go to an internist he will offer you medicine, if you go to a chiropractor he will offer you manipulation, if your go to Physical Therapist he will offer you exercise and movement therapy. Good healthcare professionals recognize in addition to nails there are bunch of nutty patients and screwy patients which may need a wrench or screw driver.

Patients do not ask for second opinion very often. When patients do ask for second opinion: it is for wanting confirmation of diagnosis or plan of care; dissatisfaction with prior consult; desire for more information (clear diagnosis); or persistence symptoms and lack of resolution of problem.

When a second opinion is indicated regarding healthcare:

  • Elective surgery is recommended
  • Diagnosis and/or treatment is not clear
  • Rare condition or diagnosis
  • When you are not given a clear explanation of how to self-manage this problem
  • If you sense that there is a lack of agreement between your expectations and what the healthcare professional expectations are, and attempts to communicate and resolve this lack of agreement is failing
  • When your healthy level of skepticism is becoming larger
  • Will Rogers said “if you find yourself in a hole stop digging”

Seeking a second opinion may feel uncomfortable for fear the action will upset your first healthcare provider. Medical ethics for healthcare professions assert that it is the patient prerogative to seek a second opinion. A good healthcare practitioner understands your right to be well informed and should support you seeking a second opinion.

Considerations when seeking a second opinion regarding healthcare:

  • Choose a healthcare practitioner who is independent of the first healthcare practitioner
  • Consider a healthcare professional from different back ground
  • Choose to inform the primary healthcare professional or to proceed in stealthmanner and not inform the primary healthcare professional
  • Take time to shop for best healthcare professional for second opinion
  • Check with your health insurance company regarding coverage of second evaluation
  • Collect and share results records from previous tests
  • Seek second opinion earlier rather than later
  • Consult with your primary care physician to help sort out conflicting opinions

As a Physical Therapist working with my patient I have pondered when should we stop digging a whole, and should seek a second opinion? I have surveyed my Physical Therapist colleagues by asking the question “how many Physical Therapy visits will you see a patient if you are not seeing progress with their problem before you refer them to another healthcare practitioner”. The responses have varied from a quizzical look, “I have never thought about that question” to a high end of six to eight visits. My belief is “three strikes and you are out”. If I and the patient cannot see any measurable improvement after three Physical Therapy visits than it is time to consider getting a second opinion from another healthcare professional.


Damien Howell Physical Therapy – 804-647-9499 – Fax: 866-879-8591 At-Home, At Office, At Fitness Facility – I come to you, I do home visits Damien@damienhowellpt.com

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