The interchange between physicians discussing a patient’scase has been mentioned in written history since ancientGreece. From the time of Hippocrates, physicians have beenencouraged to seek consultation on difficult cases when theywere in doubt. They were urged not to be jealous of oneanother but to realize their own limitations and to use theknowledge of their colleagues to help. “Nor, among physicians,do those who treat by diet envy those who employsurgery, but they even call each other into consultation andcommend one another.” It is clear, however, that there weredisagreements in those days: “Physicians who meet in consultationmust never quarrel or jeer at one another.” Therewere also “wretched quarrelsome consultations at the bedsideof the patient, with no consultant agreeing with another,fearing he might acknowledge a superior.”

Over the next 25 centuries, consultation has had its ups anddowns. Much of what was written had to do with the etiquetteand ethics of the interaction. In medieval Europe, littlechanged from ancient times. Physicians were encouraged toask colleagues for help if needed and to refrain from criticizingeach other in front of non-physicians.