Over the past several years the medical profession has been commercialized to the distrust of the hitherto credulous patients.
The credibility of the physician has been called into question as the media has exposed malpractice cases , unnecessary surgical procedures, controversial rackets and self-proclaimed medical quacks Therefore patients have began to began to rightfully question
physicians about indications, procedures, risks, and qualifications, just to name a few. More recently, because of dwindling hospital profits and insurance company claim mismanagement, doctors have taken significant reductions in reimbursements and have become quite hostile about the entire medical picture. So now, we have several of the important parties involved in the health care delivery system who are agitated and defensive. Doctors have seldom been good at running a business and now they must- or fail. Not only does that deal with finance but with patients too. A number of social trends have converged to reduce the ability of patients to have these relationships with physicians. Over-
specialization and the decline of primary care have been other reasons for deterioration in the doctor-patient relationship. The rapid proliferation of specialization amongst physicians has reduced the number in “general practice” Considerable number of researchers assume that increasing specialization will continue to ”technologize” ,”compartmentalize” and “marginalize” the doctor-patient relationship. As patients see an increasingly number of poorly co-coordinated specialists for their myriad problems, the need for case-managing generalists becomes ever more acute. Overplus, declining autonomy and the rise of the organization has been another hindrance to the progress of the doctor-patient relationship. Professional independence and autonomy has been one of the most important factors in a doctor’s work life. In order to work in a genuine manner physicians need to listen to their own voice and not succumb to the dictates of over-supervision and, written rules. They need to remain independent of organizations like insurance companies and unions. The ideal doctor-patient relationship is more conducive to “egalitarianism” as opposed to “bureaucratization”