IF YOU are worried that the grass is greener somewhere else or with someone else when it comes to healthcare providers, you can get a second opinion. It is very fashionable nowadays for patients to go off-island, to Hawaii, to the Philippines, to the U.S. mainland to get medical second opinions.

On Guam, there are plenty of choices when it comes to going elsewhere for a second opinion. Different organizations and different clinics will tout different things and have very different agendas. Not all of them have your best interest in mind.

When you are going for a second opinion, the following should be considered carefully:

1) See what’s covered by your insurance. Most insurance plans do cover second opinions. When going off-island, make sure your insurance will cover all the expenses involved in obtaining this medical second opinion. Often there are significant travel expenses involved, and you may want to investigate carefully if going off-island and staying away for a long time from your home and family and friends is indeed the best option. Ultimately, of course, you will have to obtain the means to cover what your health insurance does not cover.

2) Deal with your medical records yourself. Doctors still live in the era of fax machines. So don’t rely on your first doctor to get your records to the doctor you’re seeing for a second opinion. Instead, request your records (including lab tests, reports, X-rays and other medical scans) yourself. Getting all your records could take a while, so try to start early. And, if possible, get your records to your second-opinion doctor before your visit, so the doctor can review everything ahead of time. Once you show up for the appointment, you should ask if the doctor providing the second opinion has the entirety of the records. If he or she does not, he or she will be unable to decide the best course of action – records are everything in medicine.

3) Get a written report. Don’t assume the doctor you see for a second opinion will communicate with your other doctors. Often they do not, and they will miss the reaction you just had to chemotherapy the last round, or other details crucial and important for your care. Ask for a written report of his or her opinion, and ask that this be faxed to your primary doctor. You can also keep it in your files and carry it with you to subsequent appointments with your original doctor.

4) Don’t go in with an agenda. You shouldn’t go in to get a second opinion with the goal of having the doctor say something different than the first doctor. You’ll be best served if you go in with an open mind allowing the doctor to objectively assess all available evidence. Going for a second opinion does not necessarily mean the second doctor is better or more experienced. On the contrary, if the information you are getting is diametrically opposite of what you have been hearing, there is something very wrong. It might be a good idea to go back and check with your primary care provider to make sure everything is being done to maximize the best outcome for your care.

5) Always work with the doctor who primarily takes care of you. Ideally, your primary doctor should help you coordinate care with various specialists and make sense of their potentially conflicting opinions. This is very important not only for continuity of care, but also to avoid repeating labs and tests. A new opinion may not mean the care is better, but often that the care becomes broken up and has no continuity.

If your doctor has been doing a reasonable job taking care of you, communicating and paying attention to your symptoms and problems, there should be no reason to doubt that he or she will continue to take care of you after the second opinion. This doctor was there for you when you were first diagnosed and was able to keep things going reasonably until now. If this is the case with your provider, chances are they have your best interest at heart.

Always feel free to check back with your doctor to see what he or she thinks. An excellent professional does not feel threatened by the fact the patient went and obtained a second opinion. If your doctor gets upset because you went for a second opinion, there is something wrong.

For continuity of care, always check back. It is the best for your health.