For Matthew Solan & James Davis at St John & St Elizabeth Hospital and OneWelbeck

For Martin Klinke at London Bridge, Cromwell Hospital, Chiswick Outpatients, New Victoria Hospital, HCA Canary Wharf Clinic & One Welbeck

Second Opinions From Doctors: The Key to Ensuring your Best Treatment Path

Need clarity before surgery? Matthew Solan explains why getting second opinions from doctors matters — ensuring accurate diagnosis, exploring non-surgical treatments, and avoiding unnecessary procedures.

It’s highly common – and often wise – for patients to ask for second opinions from doctors. At the London Foot and Anke Centre, we offer diagnosis and treatment plans for all conditions affecting the Foot and Ankle. Our surgeons have a wealth of experience and are frequently asked by colleagues from elsewhere to give a second opinion. With a network of  trusted clinicians in podiatry, physiotherapy, radiology, rheumatology and sports medicine your LFAC surgeon will advise you about the entire spectrum of treatment options for your  injury or condition. 

LFAC is home to “Reluctant Surgeons” – wise clinicians who will offer surgery only where  and when appropriate, rather than rushing in. 

Conflicting Emotions and Choices 

When a patient is faced with the prospect of surgery, it often comes with a mix of emotions. 

There may be relief at the possibility of resolving a painful medical issue. In addition there is also fear and anxiety about the procedure, the recovery and the surgical risks. 

The decision to undergo surgery should be made with utmost care, clarity, and confidence. 

This is where seeking a surgical second opinion from an experienced clinician becomes crucial. 

A second opinion provides an opportunity to verify the diagnosis, reassess the treatment  plan, and explore alternative options that may not have been initially considered. Most  importantly, it empowers the patient to make a fully informed decision about their health.  Surgery, by its very nature, is a serious and invasive procedure, and experienced clinicians will often advise exploring all treatment options before recommending an operation. In fact,  the wisest surgeons view operative treatment as a last resort, only to be pursued when all  non-surgical alternatives have been exhausted. 

This article delves into the importance of obtaining a second opinion before surgery, how  experienced clinicians approach this process, the comparison between private and public  healthcare systems (like the NHS) in terms of surgical recommendations, and whether  anyone should undergo an operation without the validation of a second medical perspective.

Real case studies that promote the importance of second opinions from doctors

Many patients come to us uncertain or overwhelmed by previous medical advice. Angela Godfrey and Mr L.S. are just two examples of individuals who found clarity and reassurance by getting a second opinion from our expert consultants.

Why should I get a second opinion before foot or ankle surgery?

In medicine, second opinions from doctors serve as a valuable safety net, ensuring that the initial diagnosis and treatment plan are both accurate and appropriate. For surgical procedures, this becomes even more important because of the risks, complexities, and potential long term effects that accompany many operations. Here’s why seeking a second opinion before surgery is essential: 

  1. Ensuring Accurate Diagnosis 

Before any surgery, it’s critical to ensure that the diagnosis is correct. Mistakes in diagnosis  can lead to unnecessary surgeries, incorrect procedures, and worse outcomes. Studies  have shown that diagnostic errors are not uncommon in healthcare, and they can have  significant consequences. A second opinion allows another set of eyes—often from a  specialist with a different perspective or area of expertise—to review your case and confirm  or refute the initial findings. 

For example, a patient experiencing chronic back pain might be diagnosed with a torn ankle ligament and recommended for surgery. However, a second opinion might reveal that  physiotherapy or less invasive treatments could be just as effective in managing the injury,  thus avoiding surgery altogether. 

  1. Exploring All Treatment Options 

One of the most important aspects of getting a second opinion is the opportunity to explore  all available treatment options. An experienced clinician will provide a comprehensive  evaluation of both non-surgical and surgical treatments, emphasizing that surgery should  only be considered when other approaches have failed or are inappropriate for the patient’s  condition. 

For many conditions, there are alternative treatments such as medication, physiotherapy,  orthotics, or lifestyle adjustments that can significantly improve symptoms and quality of  life without the need for surgery. In the case of ankle pain, for example, treatments like  orthotics, supportive braces, physiotherapy and cortisone injections may be effective in  alleviating symptoms without resorting to major joint surgery.

  1. Minimizing Unnecessary Surgeries 

Surgery, while sometimes necessary, is invasive and carries significant risks. These include infection, complications from anesthesia, blood clots, or even something that makes the  situation worse instead of better. A second opinion helps minimize the chances of  undergoing unnecessary surgery, which is particularly important in cases where the risks of  the procedure outweigh the potential benefits. 

Some surgeries, such as elective procedures or operations for non-life-threatening  conditions, may not always be essential, and a second opinion can help clarify whether  surgery is the best course of action. It may turn out that a less invasive procedure, or even  no procedure at all, could achieve similar results. 

  1. Gaining Confidence and Clarity 

Facing surgery can be an emotional and daunting experience. Many patients are unsure  about the necessity of the operation, what the procedure entails, or what recovery will look  like. A second opinion can provide reassurance and clarity, helping patients feel more  confident in their decision-making process. Knowing that another experienced surgeon has  reviewed your case and agrees with the proposed treatment plan can alleviate doubts and  anxieties. 

In cases where the second opinion differs from the first, patients are empowered to ask  more questions, gather more information, and make a more informed choice about their  healthcare. This process allows for greater involvement in their own treatment decisions  and leads to better outcomes. 

  1. Avoiding Bias and Conflicts of Interest 

In certain cases, particularly in private healthcare settings, there can be financial incentives for surgeons to recommend surgery more frequently. A second opinion can help patients  avoid these potential biases by offering a fresh, unbiased perspective from a clinician who may have no financial stake in the procedure. This is particularly important in complex cases where different treatment paths are available, some of which may be less profitable but  more appropriate for the patient.

LFAC fully believe in the value of second opinion from doctors, in order to minimise unnecessary surgeries

How Experienced Clinicians Approach Treatment 

Experienced surgeons and medical professionals understand the gravity of recommending  surgery and generally take a cautious and measured approach. For these professionals,  surgery is not simply a solution but a final option after all other avenues have been explored. 

  1. Comprehensive Evaluation 

Before recommending surgery, experienced clinicians conduct thorough evaluations that  often include reviewing medical history, conducting physical examination, ordering imaging  studies (like X-rays, MRIs, or CT scans), and considering the patient’s overall health and  comorbidities. They also assess the patient’s lifestyle, goals, and preferences. 

For example, in a patient with Achilles tendon pain, an experienced clinician will not rush to  recommend surgery without first considering physiotherapy, activity modification, orthotics  and injections. 

  1. Collaboration and Multidisciplinary Approaches 

In many cases, experienced clinicians work collaboratively with other healthcare  professionals, such as physiotherapists, pain specialists, or rheumatologists, to develop a  comprehensive treatment plan. This multidisciplinary approach ensures that all treatment  options are considered before recommending surgery. 

By collaborating with experts from various fields, the surgeon can ensure that the decision  to operate is made only after non-surgical treatments have been exhausted, and the  patient’s overall health and recovery potential are considered. 

  1. Emphasis on Conservative Treatment 

Many experienced clinicians emphasize conservative treatment options as the first line of  care. This could include lifestyle changes, medication, physiotherapy, orthotics, injections,  or even watchful waiting in certain cases. These non-surgical interventions often provide  significant relief and improve patient outcomes without the need for invasive procedures. 

For conditions like osteoarthritis, where surgery may eventually be necessary, experienced  clinicians will try non-surgical interventions, such as exercise, weight loss, and medications,  before recommending joint surgery.

  1. Risk-Benefit Analysis 

Every surgical decision involves a careful risk-benefit analysis. Surgeons weigh the potential  benefits of the procedure against the risks, including the patient’s age, comorbidities, and  the potential for post-operative complications. Surgery is only recommended when the  potential benefits significantly outweigh the risks and when all other treatment options have  been tried and found to be insufficient. 

For example, in elderly patients with heart disease, a surgeon may be reluctant to  recommend a major operation unless it is absolutely necessary due to the increased risk of  complications from anesthesia or surgery itself. 

 

Should Anyone Undergo Surgery Without a Second Opinion? 

In general, it is highly recommended to obtain a second opinion before undergoing surgery.  However, there are certain circumstances where surgery may be required urgently, and seeking a second opinion may not be feasible. These include: 

  1. Emergencies 

In emergency situations, such as traumatic injuries, internal bleeding, or life-threatening  conditions there is no time for a second opinion, and patients must trust their medical team  to make the best possible decisions under the circumstances. 

  1. Complex or Rare Conditions 

In cases involving complex or rare conditions where only a few specialists are available,  patients may have difficulty obtaining a second opinion from a qualified surgeon. In these  situations, it may still be worth seeking another opinion, even if the process takes longer,  particularly if the surgery is elective or non-urgent. 

While it may not always be practical or necessary to seek second opinions from doctors in emergency cases, for non-urgent surgeries, elective procedures, or chronic conditions, a second  opinion is invaluable in ensuring that surgery is the most appropriate course of action. 

 

Private Surgeons vs. NHS Surgeons: Who Operates More? 

One of the concerns patients often have when considering surgery is whether private surgeons recommend surgery more frequently than surgeons in public healthcare systems, like the NHS (National Health Service). This comparison is relevant because healthcare  systems operate under different financial incentives, which can influence treatment  decisions. 

  1. Private Surgeons and Financial Incentives 

In private healthcare systems, surgeons are often compensated directly for the procedures  they perform, and private hospitals generate revenue through surgeries. This financial  model may create incentives for recommending surgery more frequently, particularly in  cases where less invasive or non-surgical treatments might be appropriate. 

While the vast majority of private surgeons act in the best interest of their patients, the  presence of financial incentives can sometimes lead to more aggressive surgical  recommendations. Patients in private care may feel pressure to undergo surgery more quickly or without exploring all possible alternatives. 

It is wise to avoid rushing into an operation. 

  1. NHS Surgeons and Resource Constraints 

In contrast, NHS surgeons operate within a publicly funded system that prioritizes cost effective treatments and resource allocation. NHS surgeons are salaried, and the system  places a greater emphasis on reducing unnecessary surgeries, partly to manage limited  healthcare resources. As a result, NHS surgeons usually recommend surgery only after  other treatment options have been exhausted. This approach does not mean that the  surgeon is rationing care. 

A resource-conscious approach means that NHS patients are more likely to undergo  conservative treatments, with surgery often being a last resort. While this system can  sometimes lead to a longer wait for non-emergency surgeries, it also reduces the likelihood  of unnecessary or premature surgical interventions. 

  1. Balancing Access and Appropriate Care 

It is important to note that both private and public healthcare systems aim to provide the  best possible care for patients. In some cases, patients in the NHS may seek private care to  avoid long wait times, particularly for elective surgeries. Conversely, patients in private care  may seek a second opinion within the NHS to ensure that surgery is truly necessary and that  alternative treatments have been fully explored.

Most UK surgeons work in both the NHS and private hospitals. A balanced approach is  therefore more likely than in some other health economies. 

Ultimately, the decision to undergo surgery should be based on a thorough evaluation of the  patient’s condition, irrespective of the healthcare system. Seeking a second opinion is  particularly valuable in private healthcare settings, where the financial incentives for surgery  may be more pronounced. 

Are surgical second opinions necessary?

Surgery is a significant decision that should not be made lightly. A second opinion is an  essential tool in ensuring that patients receive the most appropriate treatment for their  condition, whether that be surgery or a non-invasive alternative. By seeking a second opinion,  patients can verify their diagnosis, explore all treatment options, and gain confidence in their  healthcare decisions. 

Experienced surgeons will always give a thorough assessment of the available options, and  they generally view surgery as a last resort—only to be recommended when other  treatments have been tried and failed. 

In situations where time allows, no one should undergo surgery without considering a  second opinion. This process ensures that the patient is fully informed and has explored all  avenues before agreeing to an invasive procedure. 

Regardless of the healthcare setting, the key point is that a getting second opinions from doctors help balance  access to surgery with the necessity and appropriateness of the procedure. Ultimately, this  leads to better patient outcomes, fewer unnecessary surgeries, and a more informed,  confident approach to managing health.

So, why should I seek second opinions from doctors?
Simple – to validate your diagnosis, explore treatment alternatives, and ensure you’re making the most informed healthcare decision. 

Ready to gain clarity? Contact us today to book your consultation for a second opinion from a doctor.

Picture of Matthew Solan

Matthew Solan

Mr Matthew Solan is a consultant orthopaedic surgeon, dealing in all foot and ankle disorders. He has been with LFAC since its formation in 2003.

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