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Sunday, December 29, 2019

The Role of Second Opinions

Second Opinions

After over 40 years practicing the science and art of podiatry, I fully appreciate the role of second opinions for treatment of injuries. I am fortunate to work at an institution (Saint Francis Memorial Hospital in San Francisco) where second opinions are almost second nature. But, this is not the norm. I believe getting a second opinion for orthopedic/podiatric surgery is really a no-brainer, unless you are stuck in an emergency situation. But for most cases of elective foot and ankle surgery or difficult to treat non-surgical pain syndromes, getting at least two opinions can be helpful. It is ideal that a non-surgeon (podiatrist, therapist, primary care physician, sports medicine physician) helps you decipher the recommendations of two surgeons before you go under the knife. This is the ideal world, but hopefully, you can get this type of ideal treatment. For most patients and doctors, that is way too much work to do. But, you cannot go back and reverse a surgery. Even when the two surgical opinions are identical, you will develop a feel for which surgeon you want to do the surgery. Find out how their surgical approaches are different, and what differences there are in the postoperative treatment. Second opinions for complicated non-surgical problems are less commonly done. But, the approaches of physicians can be so different that they should be done when improvement is stymied. If a doctor/therapist ever implies that you will not get better because of your age, definitely get another opinion. Age can be a factor, but normally only a small part of a slow healing process. Take an active role in your own care; at least you and your family will have fewer surprises in the process. And, never tell one surgeon what the other one says. You want 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 the conservative treatment that I had not thought about. These opinions are worth their weight in gold. 

Golden Rule of Foot: It is best to have a non-surgeon say, “You really need elective foot or ankle surgery,” since surgeons tend to be so selective on who they cut on.

This is an excerpt from my book: Secrets to Keep Moving

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.