Unappreciated during his career and largely uncelebrated today, Ernest A. Codman made profound contributions to medical practice and outcomes research. The origin of the present emphasis on evidence-based medicine began with Codman and his "end result" idea. Codman's ideas, courage, and persistence played a critical role in the transition from the 19th century artisan style of medical practice to the current scientific basis of medicine. This historical perspective is a tribute to Codman's contributions to medical science and highlights his remarkable career.