One of the most, if not the single most important steps you will take when it comes to your facial pain is to find a doctor that you trust and respect- the perfect doctor for you. Effective long-term patient/doctor relationships must include communication and cooperation by your doctor and you.  

A rare disorder requires special knowledge, experience, and in the case of a surgeon, skill. 

Seeking a second opinion

There are even times when seeking a second opinion is not only appropriate but necessary. To find your perfect doctor, you may need to meet with more than one. You might seek a second opinion when: 

• Your doctor is not familiar with trigeminal neuralgia or neuropathic facial pain. These are rare disorders, encountered so infrequently that their management is best handled by a physician that is experienced in its treatment. 
• You lack confidence in the offered opinion. You find yourself questioning the diagnosis or treatment plan. Your doctor is not addressing your questions to your satisfaction or cannot explain why the suggested treatment plan is your best option. 
• The diagnosis is unclear. Neuropathic facial pain has many classifications and a correct diagnosis must be obtained for proper treatment. You have not had the standard diagnostic tests, such as an MRI, before your doctor gives you a diagnosis. 
• Your concerns are dismissed. You know your symptoms and how the pain feels. You have to advocate for yourself to avoid needless suffering or poor care. Your perfect doctor will take the time to listen to you, take your priorities into account, and work together with you to find the best treatment for you. 
• You want to make the right choice- you don’t need a ‘reason’ for a second opinion, and the right doctor will encourage you to ask questions, get multiple opinions, and take the time you need to make a decision that you feel is right.

Patient rights

Second opinions are a way to learn about your diagnosis and choices for treatment options. As a patient, you have rights and one of your most important rights is the ability to get a second opinion about your diagnosis. Being informed is critical in deciding your choice of treatment. Statistics show that over one third of adults in the United States will never seek a second opinion and almost one tenth of newly diagnosed patients rarely, or never understand their diagnosis. A second opinion means you are consulting with another doctor to confirm a diagnosis and/or find possible different treatment choices available to you. It is recommended to get a second opinion immediately to avoid delays in your treatment and recovery.  

How to get a second opinion

Be clear in your mind about what the reason is for the second opinion. Are you seeking an opinion, or possibly ongoing care from the new provider? Are you prepared to re-think the current diagnosis or treatment plan if this is recommended? This will focus the clinician’s attention on the part of your care that you’re concerned about. There is limited literature about the real-life benefits of second opinions, but if they are mostly being obtained for reasons of communication style and rapport, it would be plausible to assume that you will be more satisfied and do better generally with a clinician you can relate to well. 

Some doctors prefer to monitor your facial pain situation and begin with medication or use less aggressive procedures before moving to surgical intervention. Some doctors like to use more aggressive treatment methods from the beginning. By getting a second opinion, you can expand your understanding about different treatment methods which may be most suitable for you and your situation. Being informed is always your best option! Second opinions don’t hurt, and your perfect doctor should be encouraging, not disparaging about your getting another opinion. After all, it is your pain, your body, your choice. 

When the first doctor’s opinion is the same or similar to the second doctor’s, your confidence will be increased. A valid opinion and appropriate course of treatment is your best option for your return to good health or and gaining control of this pain. Let your primary healthcare professional know about your facial pain diagnosis and treatment. Communicating to your primary care doctor will help preserve that longer-term relationship and ensure the neurologist or other facial pain specialist you are seeing can get the necessary records. 

Be open with the new health professional that you are seeking a second opinion. Second opinions may lead to spending more time and effort, especially if you have to travel to another suburb, town or even state. Be aware that you may feel more obliged to follow advice you’ve gone to so much effort to obtain. This is also one of the reasons that you should have clear in your own mind what the point of the consultation is. Take your time to consider the second opinion as carefully as you did the first. 

Your perfect doctor is not

Dr. Google

Do not consider the internet to be the final word on second opinions. The smartest people in medicine are not the ones writing on blogs or Facebook or forums or selling their unique patented products. Stick to reliable, trustworthy sites from established institutions, and use this information to get a “background briefing” rather than to make a diagnosis yourself.  

Remember that doctors’ opinions may differ. A different doctor may come up with a different diagnosis for your facial pain, or offer a different opinion as to treatment recommendations. Not every doctor will have the same opinion with regard to diseases and possible treatments. Factors which may have an effect on a doctor’s opinion are: technology available to that doctor, school of thought, where they were trained, when they were trained/who they trained under, individual methods of treatment, and experience in dealing with that particular diagnosis. Treatments and best practices evolve over time, so it is important to understand a new option, even if that option did not exist when the experts who developed certain treatments were around. 

While second opinions may be awkward for doctor and patient at times, studies have shown that 30 percent of patients who sought second opinions for elective surgery and 18 percent of those who were required to obtain a second opinion by their insurance company, found that the two opinions were not in agreement. Even when you find your perfect doctor, you need to make sure you are educated properly to make the best decision for your health. 

What will it cost? Call your insurance provider before any treatment or second opinion to prevent any confusion or denial of the bill. You need to know exactly what will be covered, such as an out of network provider, any lab work or testing that may be required, and what your responsibilities are before seeking the second opinion. Diagnostic tests can be very costly, and many insurance providers will not pay for them if they were completed for the initial diagnosis. You have the right to have copies of the tests you already had done. Be an informed consumer and arrive for the second opinion with all of your previous medical records, contact information about the first physician, insurance card, list of prescribed medications and allergies, and any diagnostic test results. 

Excerpts from Cindy Ezell