The  doctor patient relationship is considered fiduciary . Doctor should have only patient’s welfare in mind and the patient is supposed to have  faith in doctor’s judgement .

The real picture is very different

There is a deep distrust in the air ,as every where .

As there is no tort reform , doctors have to practice defensive medicine . Patients are sometimes viewed as potential litigators .Doctors have to deal with EMR ,extensive documentation , administrative hassles ,shortage of manpower .

On the other hand , patient are caught unaware about newer regulation about controlled substances .As doctors are the face of these multiple agencies like insurance companies , Corporate hospitals , physicians are viewed as an allies to them . Unfortunately , that is far from truth .

Some times the anger and frustration is so extreme that they would not even stop using cuss words for the doctors

Back home in India , they go a step further .

If there is an unfortunate outcome , they would take law in their own hands . Violence against doctors , arsons at the hospitals  are not infrequent

We need to redefine and retrospect on this fiduciary relationship .

A  Physician is  not God  or Santa

Wish lists cannot be always  granted