Sometimes even the best doctors are stumped. This can occur with a common disease say migraines which takes an uncommon or difficult to treat course. And of course it happens with unusual diseases. Most start with their primary care provider, who as a generalist tries his or her best to diagnose and treat the disease. With time and lack of success the doctor refers to a specialist, who after reviewing all the charts and examining the patient will give it his best shot. What happens though when the “best shot” doesn’t hit the mark?

Well, first and foremost: Don’t panic! Most of the time the diseases in question are chronic so this buys some time. Second, ask yourself what is and is not working? Try to make a list of your complaints and be thorough.You then need to go to y0ur primary care doctor and request a second opinion. If your doctor or the specialist seems offended at asking for a second opinion, then find another doctor. A good doctor will always welcome a second opinion.

Just what is a second opinion? Another doctor, almost always a specialist, is asked to review your care and treatment plan. This doctor should be very skilled in the area of interest. You should do your homework and check via reputable internet sites about this doctor, including any papers published and reviews of patients. If you like this doctor, the next step is to get your insurance plan to approve a second opinion. By law, the insurance company must approve a second opinion when requested for conditions that are complicated or difficult to manage.

What happens next is that you will be examined by this specialist. Make sure you bring a list of questions to ask him. He will then discuss his findings with you and then forward these to your doctor. If his recommendations involve a significant change in course, then you need to be prepared to first decide if you in fact agree with this treatment and secondly, advocate for yourself.  This means asking your doctor to put in a request to the insurance company, then frequently phoning your insurance plan to ensure that everything is going well and then finally receiving the needed care.

Sometimes care involves a hospital other than your usual hospital-usually a much larger, referral center. If the second opinion physician recommends a non approved drug or treatment and the insurance company denies your care, then first do some more research: Is the drug/care truly an effective way to treat your condition? Are there published studies to back you up? If so, then talk to your doctor. Be prepared to make your case first with your doctor and then with the insurance company.

I know it’s not easy to get all of this done, but when all is said and done, it will surely be worth the effort!