@JacobFaubion I understood it as pure context, the author is just acknowledging the fact that there are cases that it is advisable for a patient to seek a second opinion, however, this leads the author to make their argument or at least begin talking about, that, in those cases, it can be awkward, for x,y,z reasons.

2nd 5/5, while i assume the difficult rated on each question is based on the stats of how many people get it wrong, it feels like some days those that are supposed to be easy questions are harder for me and the harder questions are easier for me. of course, difficulty is subjective in that sense.

same here, im in NYC too!