How to Get a Useful Second Opinion
At some point, all of us are going to need help with our health.
But, amongst our ever-expanding list of options, how do we find the help we actually need?
Choosing poorly can mean starting down a slippery slope of one bad option after another.
This article was written to sharpen your intuition, give you important questions to ask and help you avoid making two critical mistakes.
My hope is that what's below will embolden you to:
Take an active role in figuring out which treatment options are best, but also to
Help you avoid getting stuck in an echo chamber of the same, limited (often unhelpful) opinions.
So...how do we find the who (and what) among the treatment options we have in front of us?
That's not an easy question to answer, but it's definitely worth the effort.
First, we need to understand something important about how we humans are wired when it comes to answering that question.
THE PARADOX OF CHOICE
According to Barry Schwartz, author of The Paradox of Choice, when we need help with our health, only about 15% of us actually want to be involved in making the decision about the course of action to take.
Think about that--85% of the time, we'd rather not have to make the call.
This is our health we're talking about...why do we so readily turn over such an important decision to someone else?
The theory is, we tell ourselves...
It's better to not have to live with a "wrong" decision we made, then it is to have to live with a "wrong" decision someone else made.
It's this person's job to know what's best, so we reason we should lean on their expertise.
THE CHALLENGE OF OUR TIMES
We have more options (and opinions) before us today than ever before.
To me, that's exciting. We're learning more about the body every day.
Yet, the endless options in our noisy marketplace, while potentially empowering, can also be paralyzing, not to mention confusing.
If we consider too many options, we end up feeling overwhelmed with analysis paralysis.
If we consider too few, and we may end up choosing between unhelpful or even dangerous options.
Sometimes, we don't even have a choice.
Yet the paradox is, we want to have a choice, or at least feel like we do.
We want to feel in the driver's seat of our health...to a point.
If you're an adult, you already have plenty of weighty decisions to make regularly--making important ones about our health often feels like too much ask of our fatigued selves.
And so we understandably lean on someone else to tell us what to do.
That can be good, but can also come back to bite us in the butt.
A COMMON SCENARIO
Let's say you have a back problem, and the pain is becoming unbearable.
When you're in pain, you just want out of it...asap.
Being proactive, you decide to go get some imaging done, and you take those pictures to two different doctors.
THE ECHO CHAMBER PROBLEM
If you ask a two orthopedic surgeons for their recommendation, chances are you'll be told surgery is the best option.
If you ask a two chiropractors for their recommendation, chances are you'll be told surgery isn't the best option.
Here's an important point:
If you only ask for opinions in one realm (one type of medicine), chances are you'll miss a balanced perspective, and maybe the option that is best for you.
In this scenario, back surgery is no small decision.
What a surgeon probably won't tell you is that back-surgery success rates are low, not to mention the process is invasive, and the recovery can be lengthy and incomplete.
What a chiropractor probably won't tell you is that if you 1) do nothing to restrengthen the muscles of your core, and 2) do nothing to discover the subtle, daily movement patterns that are exacerbating the problem, no amount of adjustments will be able to hold your back in good alignment, and thus permanently alleviate the pain.
On top of that, neither will likely tell you that time (not treatments) is often the best healer.
BUT WHERE DOES THAT LEAVE YOU?
Doing nothing isn't a great option either.
You know taking painkillers all the time has downsides too.
So what do you do?
Side Note: Here's a quandary I've had to deal with as a body transformation specialist:
I've worked with clients who have "jacked up" vertebral alignments in their lower backs...or so it seems on their MRI. Yet, they live with no pain.
I've also worked with other clients who had MRIs and there was nothing observably wrong with their low back. Yet they live with daily, debilitating, low-back pain.
Now, you tell me, should the people in pain have a surgery, a chiropractic adjustment, or neither?
Maybe we need to zoom out?
MAYBE THERE IS A THIRD WAY
If you ask a chiropractor (Joe Dispenza)--who suffered a traumatic bike accident where multiple vertebra were literally crushed--what he would do...his answer might surprise you.
Chiropractic wasn't an option, yet he skipped the repeated advice of surgery, chose to be immobilized (face down) for six weeks, and fully healed his body with his mind.
Look it up. It's an amazing story.
How did he know/decide to do that?
Before I help you think strategically about your options, there are two more important point we need to cover.
FIRST: THE MYTH OF "INFORMED CONSENT"
Most of us have the illusion when we go to the doctor that we're given all the relevant information we need in order to make an informed choice.
Unfortunately, that's rarely the case.
Here are eight examples of common, uninformed consent.
If you knew, for example:
The success rates of back surgery are among the lowest of all kinds of surgery, would the option be any less attractive?
That plant-based diet you've been told to follow will, after what's likely no more than a few months (when you've moved on from the practitioner's care), leave you with a whole host of digestive problems, nutrient depletions, and different health challenges than you originally had, might you consider a broader nutritional perspective?
Chemo and radiation would extend your life by 2% more than if you had skipped the treatments, would that option (and the time at the doctor's office) be worth it?
HMG-coA Reductase Inhibitors (cholesterol-lowering meds like Lipitor) deplete CoQ10 from your body, which is vital for heart and immune health, would taking such meds make sense to you?
High-intensity interval training is great for fat-burning and often terrible for your joints, would you start with a different form of exercise, or is burning fat as fast as possible still the most important goal?
Proton-pump inhibitors (anti-acids) stop your body from making stomach acid (which you need to digest food), and they deplete minerals from your bones, might you look for another way to deal with heartburn?
All flu-shots contain mercury and formaldehyde, would you want an annual injection of those neurotoxins, or might there be some other measures you can take to boost your immunity each winter?
Might make you feel better
Might make you feel worse
May cause weight gain, emotional numbness, and loss of sex drive
Are literally a mind-altering substance that could cause suicidal thoughts, or in rare instances be the cause of irreversible and tragic acts of violence.
Are among the most difficult meds in the world to get off of--as in, you-might-go-crazy-trying, kind of hard...
After being told the above, would any of the options still sound like your best option?
Before I learned what I'm about to share with you below, I spent more time at the doctor's office (for my immune and musculoskeletal challenges) than I care to remember.
Never once did a doctor or nutritionist lay out for me such honest information like what you just read.
If he or she had, I would have at least had the option for truly informed consent, and I might have looked into other options sooner.
THE GREAT CHALLENGE
All health practitioners (myself included) are limited by the training and tools we have.
We can't teach you about options we don't know, or give you honest assessments of disciplines we have been trained to poo-poo.
As Upton Sinclair put it "It is difficult to get a man to understand something when his salary depends upon his not understanding it."
That said, we who help others with their health can (and should) do a much better job of honestly laying out the upsides and downsides of the tools we know of, and use.
A BETTER EXAMPLE OF INFORMED CONSENT
Let's take the case of anxiety, depression, or post-traumatic, stress disorder (PTSD).
There are a TON of factors that come together to create this difficult reality for people.
Bessel Vander Kolk, a highly-respected psychiatrist and author of the fantastic work The Body Keeps the Score can prescribe a whole host of psychiatric meds, but he rarely does so.
When he does prescribe them, he views the meds as a very short-term band-aid, lets the patient know that, and can mention a whole host of other appropriate options.
Why does he rarely prescribe meds?
He does so because he has so many other tools in his toolbox, and he knows in most cases such tools are way more efficacious, and longer lasting in their effectiveness, than meds.
Examples of options he might suggest include:
And that's just the short list.
Explaining options like that, does two things, 1) allows the patient the option for truly informed consent, and 2) allows the patient to invite the practitioner to use his intuition to help shape the choice.
Do you see the difference?
In short, what Vander Kolk does, is help people remove that overwhelm feeling of needing to decide for themselves, and partners with them bring his intuition to choosing a treatment option with a high probability of success.
A QUICK CHECKLIST I GO THROUGH WHEN LOOKING FOR HELP
One way to help yourself find the opinions that can best move the needle for you is by filtering the advice you receive through these three questions:
Which paradigm is this practitioner operating from--symptom suppression or addressing root causes? Both have their place...I'll explain below.
How broad (not necessarily deep) is this professional's toolkit? Because they tend to ignore context, specialists (medical or alternative) can have big (deep) blind spots.
Do he/she not have an answer, and instead suggests "monitoring" how you're feeling? This is often code for, "we have to wait for your symptoms to get worse before we can prescribe a treatment."
THE SECOND, SUPER-IMPORTANT FACTOR
Your experience isn't the whole story.
My experience with chiropractic changed my life--dramatically for the better. That experience is the reason I do the work I do today.
I've had clients whose experience with a chiropractor changed their life, for the worse.
So is chiropractic good, or is it a bunch of people who aren't "real" doctors?
Maybe it's not that black and white?
LET'S BE FAIR
If a profession has stood the test of time (a hundred years or more), and has a very loyal following, there's likely some real benefit it delivers.
Think about your own experience at the doctor's office.
You've probably seen some great doctors and not-so-great doctors within the same medical or alternative field. Even nutritionists and personal trainers vary widely in their skill sets.
Should you throw out a whole profession based on one lackluster practitioner?
I'd argue no.
I've often talked to people who stubbornly, (sometimes proudly), say "I'll never see a ______________ practitioner."
Is that stubbornness helpful?
Maybe there's a better way to look at our options?
For any modality that does or doesn't make sense to you...might there be important aspects you just don't understand, which if you did, would change the way you see it, and thereby the benefits you can receive from it?
You don't need to be so open-minded that your brains fall out.
Ask tough questions!
That's a GREAT thing.
But, you may find that what you don't know, and the questions you haven't thought to ask, are your biggest obstacle to finding the help you need.
Any profession will also have its newbies, slick talkers, and those with a God-complex.
It will also have its above-average practitioners, and it's humble, Jedi masters with an amazing toolkit and bedside manner.
Don't throw out the baby with the bath water, and don't be too stubborn for your own good.
FOR MY MONEY, TIME, AND SANITY
If I have a problem with my health here's how I think about it
Trauma or emergency:
Get me to a hospital (quickly), or to an orthopedic's office.
Stress or anxiety-related issues
Give me someone to talk to like a counselor or life coach to help me rethink the narratives I've been believing, and my priorities. Give me some medicinal movement, good company, good food, some time away in nature, and maybe a funny movie.
Musculoskeletal issues (joint-pain)
Find me to a (good) chiropractor, massage therapist, acupuncturist, Osteopath, cranial-sacral therapist, bodyworker, or exercise professional. If none of them can help, send me to a good therapist to make sure I'm not storing emotional trauma in my joints. If that fails, let me talk to an orthopedic, or two.
Mysterious health challenges:
Find me a health coach or consultant who can act as a triage to sort through the myriad of options and help me find the best one(s). NOTE: often this means starting with addressing the lifestyle factors contributing to the problem. A good coach can help you avoid wasting a lot of time and money looking for simple (specialist) solutions that end up being more expensive (and frustrating) in the long run.
Get me to a Function Medicine doctor, or a Naturopath. They have the diagnostic tools and training of MDs, but they tend to think differently--i.e. in general they look for causes and ways to support healing rather than suppressing symptoms. NOTE: healing tends to be slower than many wish it to be, and this route can get expensive and leave you with a lot of supplements. Revisit the bullet above.
Point me to a holistic nutritionist like an NTP (note: good nutritionists often double as chiropractors, acupuncturists, or coaches). Sometimes the more disciplines you find in one person, the more well-rounded their advice will be.
If I'm still not making progress: Help me find a master herbalist, detoxification specialist, or homeopath I can talk to.
WHATEVER ROUTE YOU GO
Get out of the echo chamber and gather opinions across different modalities.
Also, where you can afford it, don't just stick with options your insurance will cover...if you do you may miss some of your best answers.
In general, look for doctors, practitioners, and coaches who:
Exhibit great listening -- you can tell by the follow up questions they ask
Are great teachers
Have the patience of a saint--i.e. aren't annoyed by your questions
Have a great track record you can verify
Offer a diverse toolkit
Think long-term vs. short-term
Think in terms of healing not just treatments
Recognize you're intelligent enough to make good decisions about your own body
Are genuinely excited to be on "team you" and whose ego doesn't require them to be the team captain.
In short, think in terms of a building your own personal-health "board of advisors," and of building you own "health portfolio."
No one person, institution, or way of thinking has cornered the truth about health and healing. There are ALWAYS other factors to consider.
Again, get perspective from totally different paradigms...otherwise when selecting a doctor, etc... you're just judging which person you like better, not necessarily which type of treatment is best.
The better you get at seeing the big picture, and gathering useful opinions and acting on them, the better health you will enjoy.
Use your intuition in following the steps above, and you'll be on the path to finding better answers each time you need them.
If you need a personal coach, I'm here for you.
Until next time...keep learning.
That's where you find hope,
PS. Curious about the work I do? You can find out more here.