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Vol. 221. Issue 8.
Pages 476-480 (October 2021)
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Vol. 221. Issue 8.
Pages 476-480 (October 2021)
Special article
A brief history of medical cross-consultations
Breve historia de la interconsulta médica
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15
L. Pérez Sáncheza, D. Rubal Branb, E. Montero Ruiza,
Corresponding author
a Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, Spain
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Table 1. Selected information and activities of SEMI’s Comanagement and Cross-consultation Working Group.
Abstract

Physicians have long needed and sought out the support and advice of experienced colleagues. This practice, endorse by Hippocrates and Galen, remaining unchanged until the Enlightenment. During that age, cross-consultations boomed. Monographic works were written, the characteristics and qualities that consulting physician had to possess were studied the problems that it could cause were examined, and rules and guidelines to follow during a cross-consultation were established.

It remained unchanged until the end of the 19th century, when the emergence of various medical specialties offered the possibility of seeking specialized assistance. This specialization gave rise to a fragmentation of medical care which favored the emergence of the internist as a “universal consultant.” In the last quarter of the 20th century, in light of the importance of and problems arising from cross-consultation, it began to be studied on its own, specialized services were created to attend to them, and, finally, comanagement appeared.

Keywords:
Referral and consultation
Comanagement
History of Medicine
Internal Medicine
Resumen

Desde la Antigüedad los médicos han necesitado, y solicitado, el apoyo y consejo de colegas experimentados. Esta práctica fue refrendada por Hipócrates y Galeno, permaneciendo sin cambios hasta la Ilustración. En ese período, la interconsulta alcanzó un gran auge. Se escribieron libros monográficos, se estudiaron las características y cualidades que debía poseer el médico consultor y los problemas que podía originar, y se establecieron reglas y pautas a seguir durante su desarrollo.

Esta situación se mantuvo estable hasta finales del siglo xix, cuando la aparición de diversas especialidades médicas ofreció la posibilidad de buscar ayuda especializada. Esta especialización originó una fragmentación de la asistencia médica, lo que favoreció la aparición del internista como «consultor universal». En el último cuarto del siglo xx, ante la importancia y problemas de la interconsulta, se comienza a desarrollar su estudio, se crean servicios especializados en su resolución y, finalmente, aparece la asistencia compartida.

Palabras clave:
Remisión y consulta
Asistencia compartida
Historia de la Medicina
Medicina Interna

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