A neurological examination by a second physician or by a movement disorder specialist obtained to confirm the findings and diagnosis of the original examination. Seeking a second opinion is a good idea when there is any question about the diagnosis, as in early-onset Parkinson’s or when symptoms are atypical. Most medical insurance plans pay for second opinion consultations. People sometimes worry that the original physician will be offended by their seeking a second opinion, but this is a very common practice and most doctors are supportive if not encouraging of second opinions and may in fact themselves suggest them. diagnosing Parkinson’s can be a challenge as there are no definitive biomarkers to assure that the diagnosis is correct. About 20 percent to 25 percent of people receive an incorrect initial diagnosis, which can delay appropriate treatment.
For a second opinion consultation, the physician should be a specialist, preferably a neurologist specializing either in Parkinson’s disease or in movement disorders. Take copies of all test and diagnostic procedures to the appointment for the second physician to review and evaluate. It is not usually necessary to repeat diagnostic tests unless the findings are questionable or inconsistent, although the second physician may want additional tests especially if clinical evidence to support a diagnosis is scant. The second physician should perform a comprehensive neurological examination just as the first physician did, rather than relying on medical records and the first physician’s assessment, although it is reasonable for the second physician to conduct this exam differently as often there are various methods for obtaining the same assessments.
If the two physicians differ sharply in their respective diagnoses it may be necessary to obtain additional opinions. This does not happen often but it does occur, especially when the symptoms are uncharacteristic, the person is younger than is typical in Parkinson’s disease (younger than age 50), or another condition such as Alzheimer’s disease also is present. Denial is a significant factor in any chronic, degenerative disease. Consultation of doctor after doctor, particularly when findings are similar, may be an indication of denial. Most medical insurance companies refuse to pay for multiple consultations unless the physician can present evidence that such consultations are medically necessary: that is, that each doctor is providing a unique aspect of care for the person.