Second Opinions and a Culture of Shared Learning

Applying the concept of "second opinion" as a critical lens on institutions highlights and exposes concerns at the intersection of objective facts and subjective interpretation in professional contexts—calling for a second opinion on second opinions. An assessment from a different expert than the one who provided the initial opinion is not quite the same as asking for guidance in choosing a dinner from a restaurant menu.

In some use cases, one opinion is just as good as another. I like marshmallow chocolate, you like pralines and cream. No debate. In other cases, the stakes are much higher, and the divergence between opinions—especially among professionals—can carry significant consequences. Moreover, especially among professionals, less than professional second opinion practices call into question wide disparities in consequences. While seemingly technical and neutral, professional second opinion practices reflect deeper societal values about risk, responsibility, and equity—showing how American institutions have systematically chosen efficiency and liability management over the more collaborative, multifaceted evaluation systems seen in more equitable societies like Finland.

Second Opinions in Medical Care

In medical diagnoses, a second opinion can be a safeguard against errors, bias, or incomplete analysis. These scenarios require careful analysis of evidence, documented credible expertise, and transparent reasoning. The value of a second opinion lies not only in confirming or challenging the initial assessment, but also in offering a deep perspective that may excavate overlooked details or alternative solutions. Doctors and surgeons themselves routinely ask for second opinions from colleagues. In this way, second opinions serve as a vital tool for informed decision-making, bridging the gap between subjective interpretation and objective reality.

Like other professionals, doctors have different academic experiences to draw upon for insight into a given medical problem. A neurologist trained at a stroke center might identify subtle signs of a minor stroke that another doctor could misattribute to migraines. There are different schools of thought within the profession. For example, some oncologists firmly believe in aggressive treatment with maximum tolerable chemotherapy doses, while others advocate for less intensive regimens with fewer side effects and potentially better quality of life.

Doctors assess risk differently. A surgeon who has experienced rare but catastrophic surgical complications might be more hesitant to recommend an elective procedure than one who has never encountered such outcomes. Research from PMC demonstrates how probabilistic risk scores are used to stratify patients into low-, medium-, and high-risk categories for postoperative complications. Surgeons who have encountered severe complications in high-risk patients might adjust their recommendations for elective surgeries to minimize harm.

Second Opinions in Law

The term "opinion" in "second opinion" has an interesting etymology that differs from how we use "opinion" in everyday conversation. The OED explains that "opinion" originates from Middle English, derived from Old French opinion and Latin opinionem. By the late 15th century, "opinion" began to be used in professional contexts to mean a formal judgment by a judge or expert, reflecting its reliance on evidence and expertise.

In law and medicine particularly, an "opinion" has historically referred to a considered professional judgment based on facts, evidence, and expertise. When a judge delivers an "opinion of the court," they're providing a reasoned interpretation of the law applied to specific facts which is reviewable and reversible. Interestingly, when doctors provide a second medical opinion, they're offering their expert assessment based on medical evidence, training, and experience, which can be highly influential in a legal battle. So rather than being like ice cream preferences, professional opinions are more like complex interpretations of evidence in a chain where reasonable experts might reach different conclusions while working from the same factual foundation.

Second Opinions in General Contracting and Bridge Building

Asking for kitchen remodel bids is exactly like seeking a second opinion, but it’s not like deciding on a flavor of ice cream, either. Contractors aren't examining another pro's diagnosis of your kitchen's condition. They're pitching wildly different visions of what could be. One imagines sleek minimalism; another contemplates rustic charm. Each dreams up their own solution from the bare studs.

When Dr. Smith reviews Dr. Jones' cancer diagnosis, she ponders the same test results. She contemplates: "Do I concur with this assessment?" But contractors? They're not pondering each other's proposals—they're crafting competing fantasies for your future breakfast nook. Medical second opinions aim for reassuring consensus: "Yes, it's definitely appendicitis." With contractors, the seeker of help craves creative divergence, delighting when one suggests that gorgeous countertop the others never envisioned. What happens isn't seeking validation—it's more like hosting a competitive cooking show where each chef whips up their own interpretation of a dream kitchen. May the tastiest (and most affordable) vision win.

Need a second opinion on the design of that new bridge across the river?

Research from Transportation Research Record reveals the importance of collaboration between architects and engineers in bridge projects, a form of second opinion culture built on teamwork from the ground up. There was a time during the 20th century when the primary focus of bridge design was aesthetics. Architects often considered cultural, social, and spatial factors that engineers could undervalue, leading to differing risk assessments. Then mid-century the paradigm began to change:

“The scientific method has been expanded to include more than the object to be produced. This object, a bridge, is subjected to close scrutiny from every conceivable direction. Decisions concerning its appearance are no longer the values of one man, but the values of the recipient community as a whole” (John Ritner. Transportation Research Record 1044, published circa 1972).

Second Opinions in Public Education

State-level committees evaluate textbooks based on criteria established by legislative authority. This process reflects a collective professional judgment rather than individual decision-making. According to Region 9 Comprehensive Center, equitable resource allocation in schools often depends on such centralized decisions, ensuring that materials align with district goals and standards.

Yet most daily classroom work receives only one teacher's assessment. This arrangement reflects education's development as a profession where single evaluators maintain classroom authority. Unlike doctors motivated by malpractice concerns to seek colleague confirmation, teachers work in systems that couldn’t function without individual judgment. Resource limitations play a major role—schools lack funding for routine double-checking and digging deeper into student learning. The stakes feel different, too; medical mistakes can have immediate life-threatening consequences; educational judgments appear less urgent despite their long-term impact.

The system inherently values teacher autonomy over the verification that formal second opinions would provide, creating a culture where multiple professional evaluations remain the exception rather than standard practice. Grade appeals allow students to request another teacher's evaluation, fostering opportunities for reflection and learning.

Teaching in the University explains how grade appeals can be used as a learning tool, helping students critically evaluate their work and understand feedback more deeply. This practice mirrors second opinions by offering an alternative perspective but remains limited to specific cases. Students may appeal grades if the instructor deviates from the grading criteria stated in the syllabus. For instance, if the syllabus specifies that an exam accounts for 20% of the final grade but the instructor changes it to 30% without notice, this inconsistency can be grounds for appeal.

Under California Education Code Section 49066, parents and students have the right to request a grade change on specific grounds: mistake, fraud, bad faith, or incompetency in assigning the grade. This section of the code is intended to ensure that grade appeals are based on objective criteria rather than subjective dissatisfaction with the grade. The differences between an appeal and a second opinion, however, are stark. Second opinions are intended to prevent bad outcomes from happening. The patient, client, or student may not even know whether the professional in question sought a second opinion. I’ve personally experienced other teachers asking me to give my opinion on a piece of student work, especially in portfolio cultures: “Do you have time to look at this paper? I’m not sure how to respond.” But an appeal is an argument, not a collaborative second look before pulling the trigger.

Special education assessments often involve multiple professional judgments through Independent Educational Evaluations (IEEs). These evaluations are conducted by neutral third-party professionals when parents disagree with school district assessments. Under the Individuals with Disabilities Education Act (IDEA), IEEs provide a "second opinion" for determining eligibility and appropriate services. Although qualitative data derived from human observations are considered in a second opinion fashion, much of this process hinges on numerical data which puts the learner one step removed as a source of evidence.

A Critical Analysis of Second Opinion Practices in the U.S.

Medicine: Protection Over Patients

The medical profession's embrace of second opinions often functions more as liability management than patient care. Physicians routinely recommend consultations not primarily to improve diagnostic accuracy but to distribute responsibility in case of adverse outcomes. The phrase "getting coverage" is common in hospital corridors, revealing how malpractice concerns drive consultation culture. Insurance companies reinforce this by requiring second opinions before expensive procedures, prioritizing cost containment over care quality. The system weaponizes second opinions as financial gatekeeping mechanisms rather than genuine knowledge-seeking.

Contracting: The Illusion of Choice

General contractors don't reject second opinions. They've reframed them as "competitive bids" that serve contractor interests. This system creates a facade of consumer empowerment while actually placing the evaluation burden entirely on clients who lack professional knowledge. Unlike medical second opinions between equals, contracting pits professionals against each other in ways that often confuse rather than clarify options. The industry standard of three bids isn't about verification but about creating price anchoring that can actually drive costs up. The rejection of peer review ultimately serves industry profit margins while appearing to offer choice.

Education: Structural Inequity Revealed

The absence of robust second opinion mechanisms in American education exposes a systemic lack of commitment to equitable student development. Finland's education model incorporates multiple teacher perspectives through team teaching and collaborative assessment, producing both higher achievement and greater equity. American schools' inability to implement similar structures isn't merely about resources but about priorities. We maximally fund testing regimes but minimally fund teaching collaboration. This reflects a deeper commitment to sorting and ranking students than to developing their potential. The absence of second opinion structures reveals education's uncomfortable hidden purpose: maintaining existing social hierarchies rather than challenging them.

We Can Do Better

Finnish schools incorporate formal structures such as professional learning communities (PLCs), team teaching, and shared workspaces designed to promote collaboration. Finnish teachers collaborate daily during scheduled breaks and meetings, sharing resources, grading together, and solving classroom challenges collectively. Finnish collaboration emphasizes student-centered approaches like phenomenon-based learning and interdisciplinary projects, enabling holistic education.

Finland's decentralized education system allows teachers to shape policies collaboratively, while the U.S. relies more on top-down mandates that can limit creative collaboration. While both countries recognize the value of teacher collaboration, Finland's systemic emphasis on trust, autonomy, and structured support creates a more cohesive environment for teamwork compared to the U.S., where collaboration is often constrained by external pressures such as standardized testing and resource limitations. Consider this from Chung (2023):

“Finland’s positive outcomes in the Programme for International Student Assessment (PISA), administered by the Organisation for Economic Co-operation and Development (OECD), has drawn worldwide attention (Chung, 2019) and ‘cross-national attraction’ (Phillips and Ochs, 2004: 779). Research exploring the reasons behind these enviable outcomes has highlighted the strength of teacher education in the country (Chung, 2019, 2022; McKinsey, 2007). Furthermore, research has also indicated that teachers enjoy trust and autonomy in Finnish society, characterised by respect for teacher education, and for the teaching profession” (Chung, 2019, 2022).

Second Opinions as Mirrors of Society

In reflecting on these criticisms of professional second opinion practices, I want to acknowledge the dedicated individuals working within these systems. Most doctors don't personally view second opinions as merely safeguards against liability; unfortunately, the healthcare system in which they practice often structures these consultations around risk management rather than collaborative care. The institutional pressures of insurance requirements and malpractice concerns shape these practices beyond individual physicians' intentions.

Similarly, contractors don't typically frame their work around "second opinions" at all—that's not their job or how they conceptualize their role. Unfortunately, they operate within an industry where the three-bid standard often forces them to position themselves against competitors rather than focusing primarily on how clients can achieve their desired outcomes. The competitive bidding system shapes behavior in ways that individual contractors may not even recognize.

As for educators, I know that teachers and administrators have invested their lives in schools as they are. I have, too. The critique offered here isn't meant to diminish that dedication or suggest that professionals aren't doing their best within existing structures. Rather, it's an invitation to step back and examine the unvarnished system with fresh eyes. By recognizing the limitations of our current approach to professional judgment, we can begin to imagine and implement changes that better serve children—particularly those most vulnerable in our society.

The goal isn't to dismiss or replace professional expertise but to enhance it through more collaborative structures that acknowledge the value of multiple perspectives. Finnish education offers one model, but there are surely others we might develop that honor both professional autonomy and the benefits of shared evaluation.The practice of second opinions across professions serves as a powerful lens through which we can examine deeper societal values and power structures. What emerges from our analysis is not an interesting technical discussion of professional practices, but a revelation of how institutions prioritize certain outcomes over others.

In medicine, the evolution of second opinions into risk management tools reflects our society's increasing focus on liability over healing. In contracting, the illusion of consumer choice masks a system that ultimately serves provider interests. In education, the absence of robust second opinion mechanisms exposes a troubling disinterest in developing every child's potential equally.

Finland's educational model stands as a compelling counterpoint—demonstrating that when humans build systems around collaboration rather than individual authority, both excellence and equity flourish. The Finnish emphasis on teacher teamwork isn't a nice addition to their system; it represents a fundamentally different understanding of what education is for.

As artificial intelligence increasingly enters professional domains—offering its own forms of "second opinions"—we face a critical juncture. Will we use these new technologies to reinforce existing power dynamics or to reimagine how professional judgment can better serve human flourishing, lifting up those unfortunate children who live in want or neglect? The answer depends less on technical capabilities and more on our collective willingness to question whose interests our current system truly serves.

Second opinions, at their best, represent a humility about the limits of individual knowledge and a commitment to verification before action. As we move forward, we would do well to apply this principle not just to individual cases but to our institutional structures themselves—asking whether they serve the public good or preserve existing hierarchies under the guise of professional authority.