How to Use Doctor2Doctor

What this is

These answers explain how Doctor2Doctor works and how it differs from formal consultation.

Is it a formal medical consultation?

No. Doctor2Doctor is a peer-to-peer curbside advice network, not a formal consultation service. The specialist does not examine the patient, review a complete medical record, or take on clinical responsibility for the case. The treating clinician retains full responsibility for all diagnostic and treatment decisions. This distinction matters both legally and practically: it keeps the exchange informal, fast, and low-friction.

What is curbside advice?

Curbside advice is an informal, peer-to-peer clinical discussion, the kind that used to happen in hospital hallways or between colleagues over the phone. One clinician describes a case in general terms, and another offers their perspective, not as a formal consultant, but as a knowledgeable colleague.

Because the conversation is based on limited, de-identified information rather than a full chart review, it does not establish a physician-patient relationship. Clinicians have relied on this model for generations to sense-check their thinking and navigate complex cases.

Doctor2Doctor brings this same dynamic into a structured, text-based format. Instead of needing to personally know a neurologist or psychiatrist, clinicians can reach a vetted specialist network by text, without new apps or institutional contracts.

Curbside advice vs. eConsult: what's different?

The clearest way to understand Doctor2Doctor is to compare it with an eConsult, the formal alternative. An eConsult is a structured, documented specialist review billed to insurance under CPT codes. A specialist who completes an eConsult reviews the chart, enters the medical record, and takes on partial liability for the patient's care.

Doctor2Doctor works differently. The exchange is text-based and asynchronous, involves no PHI and no chart access, generates no formal documentation, and is not billable. The specialist offers informal peer input based solely on what the clinician describes. This makes Doctor2Doctor faster and lower-barrier, though it is appropriate for a different set of situations than a formal eConsult.

How this compares to other options

Doctor2Doctor is one of several ways to access specialist input. These comparisons clarify when each option makes sense.

Doctor2Doctor vs. RubiconMD and other eConsult platforms

Platforms like RubiconMD offer formal, billable specialist reviews routed through the EHR. They are appropriate when you need a documented specialist opinion included in the patient's record. Doctor2Doctor serves a different need: quick, informal peer input on cases where you want a colleague's perspective before deciding on next steps. These models address different use cases (details).

The funding model also differs. RubiconMD and similar platforms typically involve billing or institutional contracts. Doctor2Doctor is grant-supported and free for clinicians.

If your question is "Is this workup reasonable before I refer?" or "What do you think of this approach?", Doctor2Doctor is probably the right tool. If you need a formal documented opinion that becomes part of the chart, an eConsult platform is more appropriate.

Doctor2Doctor vs. MCPAP

MCPAP (Massachusetts Child Psychiatry Access Program) and similar state-based programs offer phone-based psychiatry access for primary care clinicians. Both programs share a similar goal: connecting frontline clinicians with specialist input to support better patient care. But there are meaningful differences in how they operate.

• Specialties: MCPAP focuses on psychiatry. Doctor2Doctor covers both neurology and psychiatry, including adult and pediatric subspecialties.
• Access mode: MCPAP offers real-time phone support. Doctor2Doctor is asynchronous by text.
• Geography: MCPAP programs are tied to specific states and regional teams. Doctor2Doctor serves clinicians in North Dakota, South Dakota, and Montana but draws on a national specialist network.

If you are in a state with an active MCPAP program and need real-time psychiatry support, that may be a good fit for urgent questions. Doctor2Doctor is well-suited for cases where you want thoughtful input on your own timeline.

How clinicians actually use it

A look at what the experience actually looks like, from sending a first case to common day-to-day patterns.

Texting a specialist for advice

Once enrolled, clinicians send a de-identified case summary by text. This typically includes the patient's relevant history, symptoms, current medications, lab or imaging findings, and the specific question you want answered. You do not include names, dates of birth, or any other identifying information.

A specialist on the network reviews the case and responds with informal clinical guidance, usually within 24 to 48 hours. The exchange is designed to feel like a peer conversation, not a formal handoff. You ask a question, you get a thoughtful response from someone with relevant expertise, and you decide what to do with that input. The specialist is a sounding board, not a co-provider.

Getting a specialist opinion without a formal referral

One of the most common uses of Doctor2Doctor is bridging the gap between "I'm not sure what to do here" and "this patient needs a formal referral." Clinicians use the platform to talk through a case before committing to a referral, to confirm whether their differential is reasonable, or to think through which specialist type is even the right fit.

This kind of input can save patients from unnecessary referrals and help clinicians move forward confidently with a plan (guide).

How primary care clinicians use it day-to-day

In practice, primary care clinicians tend to use Doctor2Doctor in a few recurring situations:

• A patient presents with a neurology or psychiatry question that falls outside the clinician's comfort zone, and they want a specialist's perspective before the next visit.
• A complex patient is already referred but won't be seen for months, and the clinician wants guidance on how to manage the interim period.
• A case is straightforward enough that a formal referral feels like overkill, but a quick sanity check from a specialist would be reassuring.

In each of these situations, the platform provides targeted peer input without the friction of a formal referral process. These patterns are common across primary care settings (details).

When to use it

Guidance on choosing between curbside advice, a formal referral, and other options depending on what the clinical situation calls for.

When to use curbside advice instead of referring

Curbside advice works best when the question is about clinical reasoning rather than direct patient management. If you want to confirm a differential, think through a workup, or decide whether a referral is even necessary, that is exactly what Doctor2Doctor is designed for.

If the patient needs hands-on specialist evaluation, imaging interpretation from a formal read, or a documented care plan from a specialist, a formal referral is still the right path. The two are not in competition. Curbside advice often helps clinicians decide which route to take.

Using Doctor2Doctor while waiting for a referral appointment

In rural and underserved areas, neurology and psychiatry wait times can stretch to months. Doctor2Doctor is particularly useful during this interim period. Clinicians can get guidance on initial workup, medication management, and what to monitor while a patient waits for their specialist appointment.

The goal is to support safe, thoughtful care in the meantime, while recognizing that the formal specialist evaluation is still on track. This is one of the most common use cases the program is designed for (more details).

Sense-checking your clinical reasoning

Not every question needs a formal second opinion. Sometimes a clinician just wants to know whether their thinking is on the right track before committing to a plan. Doctor2Doctor is well-suited for this.

You can describe the case and ask something as simple as "Does this approach seem reasonable?" or "Is there anything you'd do differently?" Specialists on the network are accustomed to these kinds of peer conversations. The informal, educational nature of the exchange is a feature, not a limitation, and it makes the platform easier to use for low-stakes sense-checks alongside more complex case questions.

For specialists: using Doctor2Doctor for a second opinion

Specialists may also use Doctor2Doctor differently than primary care clinicians.

Doctor2Doctor is not limited to primary care use. Neurologists and psychiatrists can also submit de-identified cases when they want subspecialty input or a peer perspective on a challenging case. If you are a neurologist who wants to think through a case with a movement disorder specialist, or a psychiatrist looking for a colleague's take on a complex treatment-resistant patient, the platform supports those kinds of informal peer discussions as well.

These exchanges follow the same model: de-identified, asynchronous, informal. They are not formal consults and do not transfer clinical responsibility. They are the kind of collegial conversations that happen between specialists who happen to know each other, now available through a structured network (details).