What is a second opinion?
A second opinion is an independent review of your diagnosis and treatment options by another surgeon. It can confirm the plan you have been given, offer a different option, or help you decide between surgery and non-surgical treatment.
Seeking a second opinion is a normal part of good medical care. The Medical Board of Australia's code of conduct lists "supporting the patient's right to seek a second opinion" as part of good medical practice. It is also part of the codes of conduct of the Australian Orthopaedic Association (AOA) and the Royal Australasian College of Surgeons (RACS).
When might you want one?
People usually seek a second opinion on a shoulder or elbow problem when:
- Surgery has been recommended and you want to know whether it is the right decision for you.
- You are unsure about your options, for example surgery or physiotherapy, or which operation to have.
- You have had a complication or an ongoing problem after surgery and want help working out what to do next.
- Your problem is complex, or a previous operation has not given the result you hoped for.
Second opinions between surgeons
A second opinion doesn't always mean seeing another surgeon yourself. Surgeons sometimes ask a colleague whether surgery or non-surgical treatment should be recommended, particularly when a patient would like reassurance about their options. This is also a type of second opinion.
Depending on the surgeon and where they work, you may be invited to a clinical meeting. At the meeting, a surgeon in training (registrar) examines you in front of a group of surgeons, who then discuss your problem and the options. It is a way to get the views of several surgeons in a short time, and it also helps surgeons learn from each case.
Dr Constantin attends the monthly meeting of the Mater Orthopaedic Department, which is made up of all the surgeons at North Sydney Orthopaedic and Sports Medicine Centre. If your case is suitable, he may suggest you are presented at that meeting.
Dr Constantin's approach
"A second opinion is not about judging another surgeon, and it isn't personal. It's a critical appraisal of a surgical problem, so that I can help you decide what's best from here."
– Dr Harry Constantin
Dr Constantin's role in a second opinion is to be fair and balanced, and to keep the focus on you and your shoulder. It is not about blame. Surgery always carries some risk, and a complication does not mean the wrong decision was made or something wrong was done to you.
What happens at the appointment
A second opinion takes longer than a standard consultation, because there is more information to go through. Dr Constantin will:
- Take a full history of your problem and any treatment so far
- Examine your shoulder or elbow
- Review all the information available, including your scans from before and after any surgery, the reports, and the operation notes
- Assess whether the treatment recommended or performed suits your problem
- Explain the risks of the operation and, if you have had a complication, what it means for you
- Talk through the options for the problem you are facing now, including non-surgical treatment
You will have time to ask questions, and you can bring a family member or support person with you.
What to bring
The more information available, the more useful the opinion. Please bring or send ahead:
- A referral from your GP or specialist
- Your scans (X-ray, ultrasound, CT or MRI), with the reports. Images on a disc or a link to them are best
- Scans taken after any surgery
- Operation notes and letters from your treating surgeon, if you have had surgery
- A list of the treatments you have tried, such as physiotherapy or injections, and your current medications
If you don't have some of these, the rooms can request them from your surgeon or hospital with your permission.
Communicating with your surgeon
With your permission, Dr Constantin will write to your GP and to your treating surgeon after the appointment. Where it is right for you, he will refer you back to your surgeon to continue your care. This is part of the professional standards set by the Australian Orthopaedic Association and the Royal Australasian College of Surgeons.
Sometimes patients prefer not to return to their original surgeon, and that is okay. Dr Constantin will talk through the next steps with you, including whether further treatment with him is appropriate.
How much does a second opinion cost?
Because a second opinion takes more time in clinic to review your information and assess you, the consultation fee reflects the longer appointment. A Medicare rebate applies with a valid referral.
Please speak to Dr Constantin's rooms on (02) 9409 0503 or team@drharryconstantin.com if you are interested in a second opinion. The team can explain the fee and the Medicare rebate before you book. See also Health insurance & fees.
Frequently asked questions
Will my surgeon mind if I get a second opinion?
Second opinions are a normal and accepted part of medical care, and surgeons are expected to support them. If you tell your surgeon, they can send your records and help with the referral.
Do I have to tell my surgeon?
No, but it helps. Your surgeon can provide the full history, scans and operation notes, which makes the opinion more useful. With your permission, Dr Constantin will also write to your surgeon afterwards.
Do I need a referral?
Yes. You'll need a referral from your GP or a specialist to claim a Medicare rebate. Your treating surgeon or your GP can write it. See Referrals.
Will Dr Constantin take over my care?
Not unless you want him to. Where it is right for you, he will refer you back to your treating surgeon. If you would prefer to continue with Dr Constantin, he will talk through the next steps with you.
What if the second opinion is different from the first?
Surgeons can reasonably differ on the best treatment. Dr Constantin will explain his reasoning and what the evidence shows, so you can make an informed decision with your surgeon and GP.
Can I get a second opinion about a problem after surgery?
Yes. If you have had a complication or an ongoing problem after shoulder or elbow surgery, Dr Constantin can review your scans and notes, explain what has happened and talk through the options from here.
How long is the appointment?
A second opinion is longer than a standard consultation, to allow time to go through your scans and records and answer your questions. The rooms will let you know when you book.
Book an appointment
If you would like a second opinion about a shoulder or elbow problem, or a recommendation for surgery, Dr Constantin can review your situation. Please contact Dr Constantin for an assessment, or call (02) 9409 0503.
If you need surgery, it will be performed at the Mater Hospital or Canterbury Hospital.
Related pages
The information on this page is general in nature and is not a substitute for individual medical advice.
Arrange a second opinion
A GP or specialist referral is needed to claim a Medicare rebate. Consultations are available in North Sydney, Kogarah and Miranda.