5 "Getting a second opinion can make a big difference."

You've just been diagnosed with ankylosing spondylitis. Your rheumatologist has recommended a knee replacement. Or maybe your doctor says it's time to start thinking about giving up something you love, like teaching or cross-country skiing. What do you do?

Take a deep breath and get a second opinion. For most doctors who spend much of their time in a clinical environment where everything is proved and proved again, second opinions may be such a fact of life that they don't even think of them as something they need to recommend. Others know referrals can create an HMO hassle and won't bring it up unless a patient does. But research suggests a second opinion can make a big difference. In one study at Johns Hopkins University, more than half of cancer patients whose second opinion altered their diagnosis heard improved prognoses, and almost all of them -- 93 percent -- had their treatment plan changed. Another study found that missed cancer cells were almost always caught when a second pair of eyes examined a mammogram. 

Perhaps even more important for people with arthritis, a second opinion can be a first step toward accurate diagnosis and effective treatment. Many forms of arthritis are difficult to diagnose because they mimic the symptoms of other conditions, making it difficult to say for sure whether your fatigue and muscle soreness are related to your RA, fibromyalgia or an entirely different autoimmune condition. Early, correct diagnosis is critical to slowing joint damage and improving long-term health. Research suggests as many as 75 percent of people experience marked joint erosion within the first two years after the onset of RA. An Australian study reported that half the people diagnosed with RA were unable to work within 10 years. Early diagnosis and treatment play an important role in ensuring an active future, so if you suspect you have arthritis, a "wait-and-see" approach can mean you'll be seeing a bleaker prognosis in the future. For major procedures like surgery, a second opinion can set your mind at ease.

What can you do? Ask your doctor for a referral to a specialist. Many people feel that asking for a second opinion is tantamount to questioning their doctor's abilities, but most doctors make referrals without a second thought when it comes to big-step prospects, like surgery or a new diagnosis. If you're uncomfortable asking straight out, you can always say something like, "My insurance plan requires a second opinion before surgery; is there a doctor you usually recommend?" The situation is trickier when you want to see another doctor because you feel your current doctor isn't giving you the care you need. In some cases, your insurance plan might allow you to switch doctors whenever you like. If you're still working with your old doctor, your best bet is just to be honest. Say, "I know something is wrong with me - it's not normal for me to be like this. I feel like you've done everything you can for me, and I think I need to see someone who specializes in my problem. Can you give me a referral?"

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