Financial Conflicts of Interest Among Oncologist Authors of Reports of Clinical Drug Trials

selves deeply to patients’ treatment (Q4) or when patients had arranged a second opinion without informing them (Q5). Specialistswhoprovidedsecondopinionsstruggledwithfeelings of helplessness toward patients if their opinion was in accordance with the first opinion and they thus took away the patient’s hope (Q6). Moreover, respondents struggled with patients’ unwillingness to be referred back to the first specialist after the second opinion. To reduce patients’ reluctance, they actively tried to restore trust in the first specialist (Q7, Q8). Respondents were hesitant to communicate minor discrepancies with the first opinion to patients, fearing this would harm the patients’ trust in the referring specialist, their own relationship with their colleague, or both (Q9, Q10). When differences in opinion were conveyed bluntly between the 2 specialists involved, this resulted in tension or anger (Q11, Q12). After back-referral, most referring specialists perceived that the physician-patient relationship had strengthened. Especially whenbothopinionsaligned,patientsgainedacceptance,certainty, and trust (Q13).