Dr Ashley Reece • Children's Doctor
Considering a Second Opinion from Dr Reece? Some thoughts and suggestions to consider
A second opinion is a clinical review for an ongoing problem for which your child is already seeing another specialist consultant.
Sometimes it is tempting to see another doctor for the same problem because the symptoms, issue or concern has not got better.
If your child is already seeing a consultant, either privately or in the NHS, and you are thinking of seeking a private review with Dr Reece please seriously consider what the reason for the additional review is, and what you hope to get out of it. The majority of such reviews confirm the diagnosis or plans already made and only rarely pick up something new or different.
There are a number of reasons why parents seek a second opinion. They may be dissatisfied with the communication, they may feel there is an alternative diagnosis or something still wrong, they may disagree with the plan of care or they may have not been able to see the doctor in person or had appointments cancelled.
Seeing a child who is already under review by a consultant for the same problem is discouraged because:
It is likely your child is being seen by a specialist who has a special interest in that clinical area and you would be best placed continuing care with that doctor.
It is very unlikely a diagnosis has been missed or there is an alternative therapy that has not been tried.
Seeking multiple opinions and potentially having many tests is unlikely to be in the best interests of your child.
If you are self-funding and are already being seen in the NHS, a private consultation and any tests arranged will need to be paid for and could be expensive, and you may end up paying for tests that have already been done or which could be done without charge in the NHS.
In private practice, we do not have access to other consultants', hospitals' or NHS records, and families often do not bring a formal referral letter detailing all the issues and summarising care to date from the clinician they are already seeing. In this situation, getting all the information in the consultation takes longer than a standard new patient consult and there is often not enough time to capture all the detail if the symptoms and issues have been going on for a while.
Having too many doctors involved can be confusing and no one knows who is leading care.
Often physical symptoms can be the manifestation of psychological issues such as anxiety, for example around school or separation, peer relationships or family issues. Where this is possible or a consideration, these should be explored before another medical review and psychologist input should be discussed with your doctor.
So a second opinion is usually discouraged unless you have discussed the need and agreed this as a plan with the consultant you are already seeing. It is appropriate and courteous for another clinician to copy correspondence to any other medical professional/s you have been seeing and this may put you in a difficult position if they are not informed.
Dr Reece suggests you are open and honest with the consultant you are already seeing and share your concerns with them, maybe in writing. This should prompt engagement and discussion about the way forward if you feel there are still problems, and asking for an alternative plan may help move things on.
This situation has worked best when the other clinical asks Dr Reece for input as a review but is still involved and remains the lead clinician.
If you are booked to see Dr Reece, his clinic is prepared in the days before by his secretary who may contact you. She may suggest you discuss the situation with Dr Reece before we confirm the appointment as it may be Dr Reece feels the second opinion is not advisable or appropriate.
So please do not be offended if we advise a private review is not appropriate, it will be suggested with your child’s best interests at heart.
If Dr Reece feels he would be prepared to see your child, you must obtain a summary of care from the consultant your child is already seeing. Most NHS consultants will not do a referral letter for a private review if they do not feel it is necessary.
Communication is key and if you are seeking a second opinion from Dr Reece then please contact him before you make an appointment. An informal telephone conversation about the speciifc issues before booking would be a good way forward if any of the above applies to your child's situation.