I love this – John of Gaddesden wrote in (I think) the 15th century, and this piece is originally entitled ‘Advice to a Young Physician.’ It’s got so much in common with the techniques common in management consultancy that the parallels are painful. See what you think:#

Advice to a young physician…Dress soberly like a clerk, not like a minstrel. Keep your fingernails well shaped and clean.

Do not walk hastily, which betokens levity, nor too slowly, which is a sign of faint-heartedness.

When called to a patient, find out from his messenger as much as you can before you arrive.

Then if his pulse and urine tell you nothing, you can still surprise him with your knowledge of his condition.

On arrival, exchange greeting, accept refreshment in the spirit in which it is offered, remark on the beauty of the countryside and of the house, and praise the liberality of the family (but only if such compliments seem merited).

Whenever possible, ensure that the patient has confessed before you meet him. If you wait until after your examination before advising him to confess, he will suspect the worse.

When feeling the patient’s pulse, allow for the fact that he may be disturbed by your arrival and by the thought of the fee you are going to charge him.

Do not be in a hurry to give an opinion on the patient. It will be more valued by the family if they have to wait for it.

Hide your instruments from the sight of the patient – and from other doctors.

Tell the patient that, with God’s help, you hope to cure him, but inform the relatives that the case is grave. Then, if he dies you will have safeguarded yourself. If he recovers, it will be a testimony to your skill and wisdom. When asked how long recovery will take, sepcify double the expected period. A quicker recovery will redound to your credit, whereas if a patient finds the cure taking longer than prophesied he will lose faith in your skill. If he asks why the cure was so swift, tell him he was strong-hearted and had good healing flesh; he will then be proud and delighted.

Behave modestly and gravely at all times.

Do not sow dissension among the servants or offer them unsolicited advice, or brawl with anybody in the house.

Do not look lecherously on the patient’s wife, daughters or maid-servants, or kiss them or fondle them, or whisper to them in corners. Such conduct distracts the physician’s mind and is likely to draw on the house the wrath of God, who is watching over the patient. It may also disturb the patient and fill him with suspicions and worries which will undo any good that may be wrought by the medicine.

If you are asked to dinner, do not be over-effusive in your gratitude, and do not quibble about accepting the place of honour at the table. Be neither indiscreet nor exacting. Do not criticise the food, even if it is millet bread which turns your stomach. Stay sober. During the meal, enquire frequently after your patient, lest he suspect that you have forgotten him in the enjoyment of his viands.

Do not talk boastfully, especially amongst great men, lest they trip you up in your own words.

Do not disparage your fellow physicians. If you do not know them personally, say that you have heard nothing but good of them.