What Role Do Second Opinions Play In Podiatric Practice?

After over 40 years practicing the science and art of podiatry, I fully appreciate the role of second opinions in the treatment of injuries and other foot and ankle pathology. I am fortunate to work at an institution (Saint Francis Memorial Hospital in San Francisco) where second opinions are almost second nature. However, this is not the norm in other areas. I believe that seeking an additional opinion for orthopedic/podiatric surgery is really a no-brainer for any patient, unless he or she is stuck in an emergency situation. 

For most cases of elective foot and ankle surgery or difficult-to-treat, non-surgical pain syndromes, multiple opinions can be helpful. I advise patients that it is ideal for a non-surgeon (non-surgical podiatrist, therapist, primary care physician, sports medicine physician) to help explain the recommendations of two surgeons before they go under the knife. For most patients and doctors, that is way too much work. However, one cannot go back and reverse a surgery. Even when the two surgical opinions are identical, a patient will develop a feel for which surgeon he or she wants to do the surgery. In my experience, it is important to understand how the surgeons’ approaches are different and what differences there are in the postoperative course. 

Second opinions for complicated non-surgical problems are less common. Regardless, the approaches of physicians can be so different that a patient warrants a closer look when improvement is stymied. Hopefully, my fellow clinicians would not imply to a patient that he or she will not get better due to age. These are cases in which an additional opinion is strongly warranted. Age can be a factor but is normally only a small consideration with a slow healing process. 

I implore patients to take an active role in his or her own care. At least, the patient and family will have fewer surprises in the process. 

I also recommend against telling one surgeon what the other one said, especially when one is truly seeking an independent opinion. I tell most of my patients that really, we are getting a second opinion on what should be done next. I am surprised when orthopedists and podiatrists that I am using for second opinions recommend another direction in conservative treatment that I had not thought about. These opinions are worth their weight in gold. 

I greatly encourage my colleagues to be open to their patients seeking second opinions. It does not mean your care is subpar. In fact, with clear patient communication and thoughtful treatment planning, additional opinions may actually enhance or validate your care.

Dr. Blake is in practice at the Center for Sports Medicine, which is affiliated with St. Francis Memorial Hospital in San Francisco. He is a past president of the American Academy of Podiatric Sports Medicine. He recently published “The Inverted Orthotic Technique: A Process Of Foot Stabilization For Pronated Feet.” One can find the book at www.bookbaby.com. 

Editor’s note: This blog originally appeared at www.drblakeshealingsole.com. It is adapted with permission from the author.