The writers of this show shared a building and a copy machine at MTM with the writers from Hill Street Blues (1981). Whenever they needed inspiration, they would look at a script from Hill Street Blues (1981) and that always pushed them to do better.
Actor William Daniels said that when he was offered the part of Dr. Mark Craig, he was not only given the pilot script to read, he was given the first three scripts to read. He said producers did this to show that his character was prominent in some episodes but not others. Daniels said it gave him a sense of the ensemble nature of the show.
Friends and family members of the cast and crew often provided the names of the doctors paged over the PA system. In several episodes, Dr. Gwyneth Paltrow is paged. Her father, Bruce Paltrow, was the series' executive producer.
Norman Lloyd got one of the lead roles as Dr. Daniel Auschlander, because he was lifelong friends with Bruce Paltrow's family. He was supposed to guest-star in only 4 episodes, but with the connection of the show, along with some response from the audience, he stayed until the show's conclusion.
The show was known for its inside jokes. The writers named characters after series staff members, they wrote lines that referenced other TV shows, movies, plays and books.