Footnotes

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Provenance and peer review Not commissioned; internally peer reviewed.

• ↵Moreover, in cases of patient-initiated second opinions where the patient contacts an entirely different clinic of their own accord, it is unlikely that physician will have any contact with the first physician before rendering their own verdict, and this is by design; the patient wants an independent assessment performed by a physician with no ties to the first.

• ↵There are two ways of failing to meet the explanatory demands. The first concerns instances when physicians are incapable of the necessary reason-giving (ie, when a difference in clinical gestalt is impressionistic rather than explicitly reason or evidence-based). The second concerns instances wherein physicians are capable of the necessary reason-giving, but do not actually rely on or seek it out when asking for a second opinion, which calls into question the indispensability of the equal-view peer-disagreement model.