Second Opinions, Without Borders
Guide 1
October 2026

Afraid to Ask, or Didn’t Know You Could? Either Way, You’re Not Alone.

Researchers who study why patients seek — or don’t seek — a second opinion have identified a consistent set of Researchers who study why patients seek a second opinion, or don’t, have identified a consistent set of barriers: shock at the moment of diagnosis, time pressure, information overload and fear of jeopardising the relationship with their doctor.[1] A systematic review of second opinions that patients requested themselves cites a study in which 47% of patients did not want to upset their physician by seeking one.[2] Patient guidance from a medical centre, a health news site and a pathology service is built around the same worry, with articles on how to ask without offending your doctor and how to get past common fears.[3][4][5]

The worry is not only on the patient’s side. In an online survey of 756 endocrinologists, 34.5% voiced concerns about potential drawbacks of second opinions, although most acknowledged patients’ autonomy and their right to seek additional perspectives.[6] An oncologist at Keck Medicine of USC reports that some doctors do take offence when a patient asks,[7] and a surgeon writing for the American Medical Association acknowledges that differing opinions can create tension between patient and physician, while urging physicians not to treat a request as an affront.[8]

There is a second, quieter barrier underneath the first: not being told that a second opinion is an option. One review found that doctors are less likely to tell older patients and patients with less education about the possibility of seeking one, which it describes as a source of health care inequality.[1] A systematic review found that people who seek second opinions tend to be more educated, have higher incomes and live in central urban areas.[9] Awareness of the right itself is often reasonably high, though. In a survey of 92 neurosurgical patients, 79% knew they could ask for a second opinion,[10] and in an Australian study of oncology patients, only 3.1% of those who had not sought one said they did not know they could.[11] The gap that matters most is that certain groups are told less, not that most people have never heard of a second opinion.

If either of these is what has stopped you, here’s what actually helps:

You do not need your doctor’s permission to seek a second opinion. Some health systems and specialists do ask for a referral, so it is worth checking what applies to you, but Med Mend does not require one. Seeking a second opinion is not an accusation that your doctor got something wrong. It is a normal part of making a serious health decision, and the American Medical Association’s Code of Medical Ethics recognises consulting other physicians as part of a physician’s duty to promote patients’ best interests.[8]

If you are worried about how to bring it up, here is language that works:

  • “I want to feel fully confident before we move forward. Would you mind if I got a second set of eyes on this?”
  • “This is a big decision for me, and I’d feel better having explored every angle before we proceed.”
  • “I would like to better understand the findings and treatment recommendations in more detail.”

None of these frames your doctor as wrong. All of them present you as someone taking your own care seriously.

You do not need a confirmed diagnosis or anyone’s approval to start asking questions. You just need to decide it matters to you.

This guide is general information, not medical advice. Please discuss decisions about your care with your treating doctor.

Listed in the order cited.

[1]  Benbassat, J. (2019) ‘Obtaining a second opinion is a neglected source of health care inequalities’, Israel Journal of Health Policy Research, 8, article 12. The barriers finding is reported from the focus group study of Peier-Ruser and von Greyerz (2018), Oncology Research and Treatment, 41, pp. 769–773. doi:10.1186/s13584-019-0289-5. Available at: https://doi.org/10.1186/s13584-019-0289-5

[2]  Payne, V.L., Singh, H., Meyer, A.N., Levy, L., Harrison, D. and Graber, M.L. (2014) ‘Patient-initiated second opinions: systematic review of characteristics and impact on diagnosis, treatment, and satisfaction’, Mayo Clinic Proceedings, 89(5), pp. 687–696. doi:10.1016/j.mayocp.2014.02.015. Available at: https://doi.org/10.1016/j.mayocp.2014.02.015

[3]  Keck Medicine of USC (2025) Don’t be afraid to get a second opinion, doctor says. Available at: https://www.keckmedicine.org/blog/dont-be-afraid-to-get-a-second-opinion-doctor-says/ (Accessed: 23 October 2026).

[4]  Next Avenue (2022) Looking for a second opinion? How to get past 3 common fears, 1 November. Available at: https://www.nextavenue.org/looking-for-a-second-opinion-how-to-get-past-3-common-fears/ (Accessed: 23 October 2026).

[5]  HONEST Pathology (2026) How to ask for second opinion without offending my doctor? Available at: https://honestpathology.com/how-to-ask-for-second-opinion-without-offending-my-doctor/ (Accessed: 23 October 2026).

[6]  Derevyanko, O. (2024) ‘8463 Navigating medical decisions: a study of second opinions from both the physician and patient standpoints’ [conference abstract], Journal of the Endocrine Society, 8(Supplement_1), bvae163.1063. doi:10.1210/jendso/bvae163.1063. Available at: https://doi.org/10.1210/jendso/bvae163.1063

[7]  Grebow, J. (2024) ‘Why I’m not offended when my patient wants a second opinion’ [interview with Minh D. Nguyen, MD], Keck Medicine of USC Physician Blog, 22 August (updated 23 April 2025). Available at: https://www.keckmedicine.org/physician-blog/why-im-not-offended-when-my-patient-wants-a-second-opinion/ (Accessed: 23 October 2026).

[8]  Bitterman, A.D. (2025) ‘Second opinions are a good idea—but there are caveats’, American Medical Association, 28 April. Available at: https://www.ama-assn.org/public-health/prevention-wellness/second-opinions-are-good-idea-there-are-caveats (Accessed: 23 October 2026).

[9]  Greenfield, G., Shmueli, L., Harvey, A., Quezada-Yamamoto, H., Davidovitch, N., Pliskin, J.S., Rawaf, S., Majeed, A. and Hayhoe, B. (2021) ‘Patient-initiated second medical consultations—patient characteristics and motivating factors, impact on care and satisfaction: a systematic review’, BMJ Open, 11(9), e044033. doi:10.1136/bmjopen-2020-044033. Available at: https://doi.org/10.1136/bmjopen-2020-044033

[10]  Gagin, R., HaGani, N., Zigelboim, E. and Shinan-Altman, S. (2019) ‘Patient-initiated second opinions during acute hospital care’, Patient Experience Journal, 6(3), pp. 66–73. Available at: https://pxjournal.org/journal/vol6/iss3/9/

[11]  Olver, I., Carey, M., Bryant, J., Boyes, A., Evans, T. and Sanson-Fisher, R. (2020) ‘Second opinions in medical oncology’, BMC Palliative Care, 19, article 112. doi:10.1186/s12904-020-00619-9. Available at: https://doi.org/10.1186/s12904-020-00619-9

More you know,
the better you decide.

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