Recently few incidents in my clinic have provoked me to ask this question to my fellow doctors. I am often being visited by patients who need a second opinion about a treatment and recommendation made by another doctor. Unfortunately, at times, I have found the recommendation was not made for the best interest of the patient or may not be the best therapeutic option. In such cases, what should be my stand?

Should I inform the patient that the previous diagnosis was wrong (that might be defaming for one of my esteemed colleagues)? Or should I be diplomatic in expressing just my opinion without commenting on the previous diagnosis? Does referral for a second opinion ever come from a doctor's side? or it is always a patient's decision?