Relations between doctors: case conferences, consultations and criticising a colleague (Law 23 of 1981, arts. 19 to 32)

What it is

Law 23 of 1981 devotes Chapter II of Title II (arts. 27 to 32) to doctors' relations with their colleagues, and several articles of Chapter I to case conferences (arts. 19 to 21 and 24). The basis is mutual loyalty and consideration (art. 29). The law forbids disapproving, in words or otherwise, a colleague's conduct towards patients, and makes it worse if the aim is to take over the patient (art. 30). Professional disagreements are settled by the Colombian Medical Federation (art. 31), and those with ethical content by the medical ethics tribunals (Decree 3380 of 1981, art. 22). This loyalty is not a pact of silence: the regulation clarifies that differences of opinion voiced prudently while discussing a case are not disapproval, and the duty to the patient prevails when a colleague puts patients at risk.

Key articles

• Art. 19: the treating doctor may ask colleagues to join a case conference on the patient; art. 20: the patient or close responsible relatives may choose the surgeon or specialist they trust.
• Art. 21: the frequency of visits and conferences depends on severity, the need to clarify the diagnosis or improve treatment, or the wish of the patient or family.
• Art. 24: in case conferences all participants charge the same fee; the regulation adds that fees take into account the patient's economic and social situation and are agreed beforehand (Decree 780 of 2016, art. 2.7.2.2.1.1.18).
• Decree 780, art. 2.7.2.2.1.1.17: a case conference is the consultation or advice the treating doctor requests from one or more professionals given the patient's condition.
• Art. 27: the doctor treats a colleague, the colleague's spouse and dependent first-degree relatives without charging fees, unless they have health insurance or the treatment is psychoanalytic; art. 28: the colleague pays for supplies.
• Art. 29: mutual loyalty and consideration are the foundation of relations between doctors.
• Art. 30: the doctor shall not disapprove, in words or any other way, colleagues' conduct towards patients; it is aggravating if the aim is to replace the treating doctor.
• Art. 31: the Colombian Medical Federation settles professional disagreement; Decree 780, art. 2.7.2.2.1.1.20: if it has ethical content, the medical ethics tribunals settle it.
• Art. 32: it is censurable to accept the post of a colleague dismissed without just cause (except management or trust posts) and to seek for oneself a job another is doing.

What it covers

• Case conferences and consultations: when they are requested, who chooses the participants and how they are paid (arts. 19 to 21 and 24).
• Care between colleagues: no fees for the colleague and close dependent family, unless they have health insurance (arts. 27 and 28).
• Loyalty and criticism: no disapproving a colleague in front of patients, and disagreements settled through professional or ethical channels (arts. 29 to 31).
• Posts and jobs: no taking the post of a colleague dismissed without just cause, and no seeking another's job (art. 32).

In clinical practice

• A patient arrives on a treatment the new doctor disagrees with: explain one's own plan and reasons without disparaging the colleague in front of the patient; if in doubt, talk to the colleague.
• In a consultation, the specialist answers for the quality of the opinion and the treating doctor decides; both record it in the medical record.
• Loyalty does not cover harm: if a colleague's conduct puts patients at risk, the duty to them prevails and the ethics tribunals are available.
• Critically discussing a case at a morbidity and mortality meeting is not disapproving a colleague: it is learning from error, respectfully and without exposing the patient.

Status and official text

• Official text verified on 2026-11-13 on funcionpublica.gov.co (Law 23 of 1981 and Decree 3380 of 1981) and on minsalud.gov.co (Law 23 of 1981 and Decree 780 of 2016); art. 27 was read in the Ministry's PDF of Law 23.
• Regulated by Decree 3380 of 1981; its arts. 15, 18 and 22 are compiled in Decree 780 of 2016 (arts. 2.7.2.2.1.1.17, 2.7.2.2.1.1.18 and 2.7.2.2.1.1.20).
• Decree 3380 of 1981 (art. 21, original text) clarified that differences of opinion voiced prudently while discussing a case are not disapproval; that article, like art. 20 on fees with insurance, does not appear in the Decree 780 of 2016 compilation: check whether it is still in force before citing it.
• Law 1164 of 2007, art. 37 (right to a good name), asks that the team's limitations or failures not be mentioned to undermine them, except when necessary and fair for the good of third parties.

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Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.

Sources: Ley 23 de 1981, arts. 19 to 32 (Función Pública, Gestor Normativo, 1981); Ley 23 de 1981 (PDF text; art. 27) (Ministerio de Salud y Protección Social, 1981); Decreto 3380 de 1981, regulating Law 23 of 1981 (Función Pública, Gestor Normativo, 1981); Decreto 780 de 2016, arts. 2.7.2.2.1.1.17 to 2.7.2.2.1.1.20 (Ministerio de Salud y Protección Social, 2016); WMA International Code of Medical Ethics (2022), paras. 30 and 31 (World Medical Association, 2022).

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