Why We Need Second Opinions

In the United States education system, teachers operate in isolation despite digital connectivity, creating a structural weakness in our approach to teaching and learning. This piece examines how "second opinion" practices have transformed fields like medicine, law, art authentication, engineering, and finance, where institutionalized collaborative assessment leads to dramatically improved outcomes.

Contrasting Finland's collaborative teaching model—where educators spend nearly half their time in joint planning—with America's isolated approach reveals the cost of our current system. As artificial intelligence enters education, robust collaborative frameworks become even more essential for identifying biases, establishing implementation guardrails, and incorporating diverse perspectives. If bridge designs, medical diagnoses, and billion-dollar investments deserve multiple viewpoints, surely our children's futures warrant the same careful consideration.

Medical Care

The concept of seeking multiple medical opinions has deep historical roots, but the formal recognition of second opinions began taking shape in the mid-20th century. In the 1950s, a radiologist made the recommendation that "dual reading" could contribute to improved radiography interpretation, a concept that remains relevant today and extends beyond just radiography. Since then second opinions have become a core factor in improved outcomes. A recent Mayo Clinic (2017) study found that 88% of patients seeking second opinions received a new or refined diagnosis. Without that second opinion, thousands would have received inadequate or inappropriate treatment.

The study reviewed the records of 286 patients referred from primary care providers to Mayo Clinic’s General Internal Medicine Division over a two-year period. The researchers compared the initial diagnosis from the referring provider to the final diagnosis after Mayo Clinic’s evaluation. Only 12% of patients had their original diagnosis confirmed. In 66% of cases, the second opinion led to a refined or redefined diagnosis, and in 21% of cases, the diagnosis was completely changed.

This tradition continues and has even intensified. Whenever a primary care doctor refers a patient to a specialist, such a case is a second opinion case. Whenever a patient is not in-network and seeks medical attention from elsewhere, insurance providers require and fund a second opinion for full coverage.

Law: Japan's Revolutionary Saibanin System

For centuries, Japan's criminal trials were conducted exclusively by professional judges, resulting in an extremely high conviction rate exceeding 99%. A jury system was briefly introduced in 1923 under Prime Minister Katō Tomosaburō, but it was rarely used and lapsed by the end of World War II. For almost another full century, defendants in Japanese courtrooms were not entitled to a second opinion. Then, after two decades of working on the problem, Japan's legal system underwent a transformation in 2009 with the introduction of the "saibanin" (lay judge) system.

The new system introduced a form of institutionalized second opinion by requiring panels of three professional judges and six ordinary citizens to collaborate on decisions in serious criminal cases. This reform recognized that professional legal expertise, while valuable, benefits from the fresh perspectives of people with different life experiences. The system has been credited with making Japan's notoriously conviction-prone courts slightly more balanced, showing how second opinions can strengthen even centuries-old institutions.

In particular, Japan's Saibanin system, while only modestly reducing the nation's extraordinarily high conviction rate from 99.8% to 97.8%, has triggered significant upstream changes in Japan's criminal justice system. Prosecutors have become more selective; the prosecution rate for murder cases plummeting from 56.8% to 28.2%, since cases must withstand lay judge scrutiny.

The system has also transformed courtroom practices by emphasizing direct testimony over written confessions, mandating electronic recording of interrogations, and reducing aggressive evidence-gathering tactics. These changes reflect how the institutionalized second opinion provided by ordinary citizens serving alongside professional judges has influenced the entire justice pipeline—not just verdicts, but charging decisions, evidence standards, and procedural safeguards.

Art: The Rembrandt Authentication Revolution

Established in 1968 with funding from the Netherlands Organisation for Scientific Research (NWO), the Rembrandt Authentication project set out to systematically examine and catalog paintings attributed to Rembrandt, the Dutch master, bringing scientific second opinion to questions of authenticity that had previously relied primarily on individual connoisseurship. Before this initiative, approximately 700 paintings were attributed to the Dutch master. After examination by the RRP team, that number was reduced to 340.

The Rembrandt Research Project (RRP) pioneered a methodical approach to attribution that transformed how we understand Rembrandt's body of work. The RRP sought to avoid subjective arguments by basing attributions on concrete evidence. Through analysis of painting techniques, examination of paint compositions, panel wood studies, and x-ray analysis, the project revealed underlying "discovery" drawings that could indicate whether a work was original or a copy. The project's findings were meticulously documented in their six-volume publication, "A Corpus of Rembrandt Paintings," which became the authoritative reference for auction houses, dealers, and scholars working with Rembrandt's oeuvre.

Engineering: The Quebec Bridge Disaster and Its Legacy

The Quebec Bridge was a steel cantilever bridge with a main span of 548 meters that collapsed during construction on August 29, 1907. This disaster, which claimed the lives of 75 workers, stemmed from multiple design flaws and oversight failures that might have been prevented through proper review processes. The Royal Commission investigating the collapse got to the bottom of the catastrophe.

The 1907 collapse stemmed from a cascade of problems. The disaster investigation identified several fatal flaws: compression chords in the anchor arm buckled due to a defective design; the project specifications permitted dangerously high stresses that exceeded established engineering practice; engineers grossly underestimated the dead load in their calculations and never revised these figures despite mounting evidence; and most tragically, clear warning signs including excessive deflection and abnormal strain in structural components were either ignored or inadequately addressed.

Chief Engineer Theodore Cooper faced particular criticism for his oversight failures, especially regarding design modifications and material specifications. This combination of design errors, poor construction practices, and failure to heed warning signs transformed engineering standards worldwide, leading to the formalization of peer review processes.

The engineering peer review process begins when project stakeholders recognize the need for independent evaluation of a design. A sponsor appoints an independent steward who collaborates with the project team to define the scope and rigor required. The steward then assembles a panel of experienced engineers with relevant expertise but no involvement in the original design.

As the review commences, the design team presents their work, explaining key assumptions, methodologies, and calculations. Panel members meticulously examine drawings, specifications, and load calculations, probing for potential weaknesses. They scrutinize critical elements like the Quebec Bridge's compression chords, checking if material specifications can withstand anticipated stresses. During deliberations, reviewers might identify concerning issues—perhaps underestimated load calculations or questionable material specifications. They document these findings, categorizing them by severity and potential impact on public safety.

The panel chair then presents these findings to the project team, initiating a collaborative dialogue. Engineers must address each concern, either by modifying designs or providing compelling evidence supporting their original approach. For big issues, the panel may require demonstration of compliance through additional calculations or testing.

This systematic process continues until all significant concerns are resolved, creating a documented trail of engineering judgment that serves both as quality assurance and legal protection. Only when the panel is satisfied does the project advance, with public safety secured through collective expertise—second opinion practice at its finest.

Finance: Warren Buffett and Charlie Munger's Structured Second Opinions

Warren Buffett and Charlie Munger's relationship spanned over 60 years of friendship and more than 40 years of business partnership. While they frequently disagreed, Buffett noted they "never had an argument" despite differing views on many things.

Munger's influence transformed Buffett's investment approach. In 1965, Munger told Buffett his purchase of Berkshire had been "dumb" and provided constructive guidance, advising him to "add wonderful businesses purchased at fair prices and give up buying fair businesses at wonderful prices." Buffett acknowledged, "It took Charlie Munger to break my cigar-butt habits and set the course for building a business that could combine huge size with satisfactory profits." This shifted Buffett from buying extremely cheap but mediocre companies.

A key to their success was Munger's understanding of cognitive biases, including what he called the "Lollapalooza effect"—the convergence of multiple biases that can drive investors toward irrational outcomes. The value of their second opinion practice is evident in Berkshire Hathaway's amazing performance, outperforming the market every year going back to the 1960s. As Buffett stated about Munger: "He's given me a lot of good advice over time... my decisions have been better. I've lived a better life because of Charlie."

Finland's Teacher Collaboration Model: A Second Opinion Breakthrough in Education

Finland's education system has changed almost as remarkably as Japan’s trial system. This nation now consistently ranks among the world's best education systems, having emerged from relative obscurity to become what education expert Linda Darling-Hammond calls "a poster child for school improvement." This system ensures that no single teacher's judgment determines a student's educational trajectory.

Nearly half of teachers' school time is dedicated to "hone practice through school-based curriculum work, collective planning, and cooperation with parents," creating multiple checkpoints and perspectives in the assessment process.Finnish teachers meet at least one afternoon each week to jointly plan curriculum and develop teaching approaches. Schools in the same municipality are also encouraged to collaborate and share materials.

The results speak for themselves. By rejecting bureaucracy and embracing collaborative instruction and assessment, Finland shows that systematized second opinions can elevate an entire profession. The collaborative approach is facilitated by reasonable teaching loads. Finnish teachers teach approximately 600 hours annually (about 18 hours weekly), while American teachers nearly double that with over 1,080 hours annually. This lighter teaching load provides Finnish teachers more time to plan thoughtful lessons and collaborate effectively.

Darling-Hammond notes that in high-performing jurisdictions like Finland, "the role of research in teaching was very highly developed." Finnish teachers are trained as researchers, with teacher preparation including examining educational research, interpreting findings, and completing a research thesis. This research orientation helps teachers become "sophisticated diagnosticians" who can collaboratively design instruction based on evidence. A research orientation almost by definition embraces a second opinion orientation. A truly scientific approach to classroom assessment would inevitably involve principled collaborative data collection/sharing and analysis work on a routine basis.

The Missing Piece in K-12 U.S. Education: Second Opinion Practices

While Finland has embraced collaborative assessment as a cornerstone of educational excellence, the United States education system stands in stark contrast, relying heavily on isolated teacher judgment and standardized testing. American teachers typically function as isolated practitioners behind closed classroom doors. Unlike their Finnish counterparts who spend nearly half their time collaborating on curriculum and assessment, U.S. teachers spend the vast majority of their working hours delivering direct instruction with minimal time for professional collaboration.

As already noted, the average American teacher spends over 1,080 hours annually on classroom instruction compared to Finland's 600 hours, leaving precious little time for collaborative planning or assessment. This isolation creates a system where assessment becomes an individual burden rather than a collaborative opportunity. A single teacher's perspective determines a student's educational trajectory with limited external input or collegial review.

In many U.S. schools, teachers rarely observe colleagues teaching or engage in substantive discussions about student work, assessment practices, or instructional strategies. This professional isolation extends to assessment design. Teachers independently create, administer, and evaluate student assessments without the benefit of multiple perspectives.

Paradoxically, while teachers are isolated in their assessment work, they are simultaneously removed from consequential assessment through standardized testing. High-stakes standardized tests are the primary metric for evaluating student achievement, teacher effectiveness, and school quality. These tests reduce the complex process of learning often to multiple-choice questions and computer-scorable formats that constrain student responses so that they can be efficiently administered and scored.

Unlike Finland's approach of empowering teachers as researchers and "sophisticated diagnosticians," standardized testing diminishes teacher agency and professional judgment. When test scores become the dominant measure of success, teachers' observations, professional expertise, and nuanced understanding of student learning are devalued. The system creates what Linda Darling-Hammond calls a "teaching to the test" culture that narrows curriculum and reduces authentic learning experiences.

Perhaps most critically, the U.S. system provides virtually no role for students in their own assessment. While Finnish teachers engage in "cooperation with parents" and view assessment as a collaborative process, American students are typically passive recipients of grades and test scores rather than active participants in understanding their own learning. This contrasts sharply with the other examples in this essay from Warren Buffett and Charlie Munger's collaborative dialogue to Japan's Saibanin system that brings diverse perspectives to legal judgment.

The isolation of American teachers from meaningful assessment work represents a systemic failure to implement the second opinion principle that has proven so valuable across other disciplines. While engineers conduct rigorous peer reviews to prevent catastrophic failures like the Quebec Bridge disaster, and the medical profession has institutionalized second opinions to improve diagnostic accuracy, American education continues to operate on a model that isolates rather than collaborates. The model standardizes rather than personalizes, and it excludes rather than includes the very students whose learning is being assessed.

This systemic, intentional isolation not only affects student outcomes but also contributes to teacher burnout and attrition. Without the collaborative support, shared responsibility, and professional dialogue that characterizes Finland's system, American teachers bear the full weight of educational challenges alone. The contrast could not be more clear: while Finland has created a "teaching and learning system" built on collaboration and multiple perspectives, the United States continues to operate an education model that ignores the transformative potential of systematized second opinions.

One promising model for instituting meaningful second opinions in education comes from Underwood (1998). This work documented a California middle school's implementation of a portfolio assessment system that fundamentally changed how English teachers collaborated to evaluate student work. Underwood's approach introduced "three progressive lenses: warm, value free; cool, analytical; and hard, critical" through which student work was systematically assessed in a teacher-as-jury system.

This three-lens methodology represents a departure from traditional single-teacher assessment. By collaboratively examining student work from multiple perspectives and with common evaluative frameworks, the system inherently incorporates multiple viewpoints—similar to how medical diagnoses benefit from different specialists' insights or how engineering designs improve through diverse technical reviews.

What makes Underwood's approach potentially valuable is that it provides a theoretical model that institutionalizes second opinions within the assessment process itself. Rather than relying on the happenstance of individual teachers choosing to collaborate, the three-lens portfolio methodology builds multiple perspectives into the system's architecture. This approach acknowledges what other professions have long recognized: that important evaluations benefit from structured diversity of perspective.

The Portfolio Project also demonstrates how educational assessment can become more deliberative and less reactive. Just as Warren Buffett and Charlie Munger's investment partnership creates space for careful consideration before committing resources, portfolio assessment creates time for reflection and multiple readings before rendering final judgments about student work.

Moving Forward

What these diverse examples show is that second opinions aren't about distrust—they're about acknowledging human limitations and the complexity of knowledge. Whether in medicine, law, art, engineering, finance, or education, they serve as essential quality control in a world where expertise is both necessary and fallible.

The emergence of AI in education makes second opinion practices not just valuable but essential. First, multi-perspective review of AI-suggested curriculum helps identify potential biases or gaps in AI recommendations that a single educator might miss. Second, structured second opinions create necessary guardrails for AI implementation as diverse viewpoints can catch problematic applications before they affect student learning. Third, collaborative teacher networks sharing AI integration experiences provide real-world validation of applications, preventing isolated experimentation that might harm student outcomes.

Finally, institutionalizing student participation in evaluating AI tools introduces crucial perspectives from the very individuals these technologies serve. Just as Finland transformed education through collaboration and Japan reformed its justice system through diverse participation, educational institutions must develop formal second opinion frameworks for AI integration that balance innovation with careful, multi-perspective evaluation. The stakes—our children's educational futures—demand nothing less.

Finland's success demonstrates that incorporating second opinions doesn't need to create inefficiency or undermine teacher authority. On the contrary, by building collaborative assessment into the system, Finland has strengthened teaching as a profession while improving outcomes for students. By adopting structured frameworks that encourage examining student work through different lenses, schools can create systems where second opinions become standard practice rather than rare exceptions used only when charges of unethical behavior on the part of a student are made. After all, if bridge designs, medical diagnoses, and billion-dollar investments deserve multiple perspectives, surely our children's futures deserve the same.