A second opinion is the process of seeking an evaluation by another to confirm the diagnosis and treatment plan of a primary physician or specialist, or to offer an alternative diagnosis and/or treatment approach.

Doctors often have differing viewpoints as to how a particular medical problem should be managed, whether through surgery, less invasive medical treatment means or more holistic approaches. One physician may prefer to take a "watchful waiting" approach before recommending surgery, while another may believe in performing surgery as soon as possible to avoid later complications. Both the education and experience of a doctor in a given medical area can also influence the advice they offer a patient. In many cases, several different treatments may be viable options for a patient. Medicine is not as black-and-white as many patients are led to believe, and physicians are not infallible. For these reasons second opinions are an important part of the process of informed consent and decision-making.

Getting a second opinion is a good way to get additional expert advice from another doctor who knows a lot about treating your particular medical problem. Dr. Metzger has extensive experience in a variety of areas:

• Endometriosis: Dr. Metzger is recognized internationally as one of the leading experts in endometriosis. She has spent the past 20 years developing novel approaches to this complicated disease.
• IVF: Dr. Metzger was director of the program at the University of Connecticut for 3 years but no longer does IVF. She can provide all of the treatment options and how they relate to your situation.
• Laparoscopic & other gyn surgery: Dr. Metzger has performed approximately 3000 laparoscopic procedures. About 4 years ago, she made the decision to give up her surgical practice in favor of an integrative medical practice. Although Dr. Metzger no longer performs surgery, she is available for second opinions regarding surgery, can discuss all of the treatment options available, and can refer patients to surgeons who are appropriate for their needs.
• Chronic pelvic pain: Recognized as one of the pioneers in the diagnosis and management of chronic pelvic pain, Dr. Metzger has developed an integrative approach to address all of the sources of pain.
• Integrative medicine: For the past 15 years, Dr. Metzger has integrated other areas of medicine as well as alternative medicine into her practice.
• Lyme disease: Dr. Metzger has treated approximately 1000 patients with Lyme disease using an integrative approach. She is also a member of the International Lyme and Associated Diseases Society (ILADS) and the California Lyme Disease Association (CALDA).

Second opinions are best done in Dr. Metzger’s office where a physical exam can be performed, particularly for patients with endometriosis, those contemplating surgery, and those with chronic pelvic pain. However, it is not always practical for a patient to come to California. In that case, Dr. Metzger will review the records and suggest possible solutions.

The other limitation of second opinions is that it is best for defined questions such as ‘is surgery the only option?’, ‘should I do surgery or IVF?’, ‘what other options should I consider for treating my Lyme disease?’, etc. More complex medical situations would be better addressed through a consultation.

Please call our office and let us know that you are sending the materials so that we can give you an estimate of when to expect a response. Then, send your records to Dr. Metzger's office. Once Dr. Metzger has reviewed your records, she will send you a letter detailing her observations and recommendations.

If you were only seeking an expert opinion, that ends the process. You are free to share Dr. Metzger’s letter with your regular physician to decide on the best course of treatment for your case. If, after reviewing Dr. Metzger’s recommendations you have further questions or want to schedule an appointment please call Dr. Metzger's office directly at 650-229-1010.

Documents and Materials Essential for a Record Evaluation:

1. All records should be sent in a single package
2. A personally written statement (when the problem began, what treatments you received and what question you have regarding your health issue)
3. Operative and pathology reports if you have had pelvic surgery
4. Reports from MRI’s, CT scans, ultrasounds, stool tests, allergy tests etc. Please do not send x-rays!
5. Copies of blood tests from the past 5 years.
6. A copy of current office dictations from your physician or other consultants, if available
7. Appropriate fee as noted below.

Fees: There is a fee of $175 (U.S) for a record evaluation. Please send payment with your request and materials. The $175 fee is not reimbursable by insurance companies as a second opinion.

Mail requests for record review, all required materials and payment to the address below.