—We are pleased that Dr Moldawsky appreciated our article. Telephone contact between the referring physician and the consultant is sufficient in many cases, and we would include that under the rubric of "direct personal contact" that was suggested in our article. We certainly agree that one might easily list additional commandments, one of which could be that the patient should be aware that the consultant is coming. We would argue, however, that it might not always be preferable for the patient to be told all of the reasons for which a consultation was requested. For example, we have seen patients who would be unduly alarmed if they were told that a consultant who was called to interpret unimportant ECG changes was coming to see if the patient had had a heart attack.