Why does a patient ask for a second opinion after seeing me? When a patient walks out of your process and goes looking for a second opinion, read it as a signal. Something on the trust side came up short. You didn't deliver enough of the big, outrageous, memorable things that make a patient feel certain about you, and that gap is what sends them shopping. These outbound second opinions are hard to win back, so the better fix is upstream. Build so much trust that they never feel the urge to leave. Case reports matter here more than almost anything. [...]