title: A caring partnership: can we gain control?
abstract: BACKGROUND
  The health care system in the United States is in trouble. Patients and physicians are becoming increasingly unhappy with the system. There has been a progressive deterioration in trust in the system and in patient-doctor interactions.
  
  
  RESULTS
  The history of the evolution of medicine as a profession over the past 350 years is briefly reviewed. The forces that have changed a paternalistic, but caring, system into one that is no longer paternalistic, but also less caring, are discussed. It is suggested that the current market-driven, industrial model is failing both patients and physicians, and that it is too costly.
  
  
  CONCLUSIONS
  The case is presented for patients and physician to join forces to work for reforms of the system, to encourage more physicians to take up careers in primary care, to fund health insurance for the uninsured, and to subsidize the education of future physicians. These approaches should help restore trust and a caring partnership between patients and their physicians. This partnership is necessary for attaining the reforms suggested.
authors.affiliation: Center for Medical Ethics, Mail Code 153, Albany Medical Center, 47 New Scotland Avenue, Albany, NY 12208, USA. balintj@mail.amc.edu
authors.forename: John A
authors.initials: JA
authors.lastname: Balint
mesh_terms: D003695:Delivery of Health Care / Q000266:history / Q000639:trends*; D018166:Health Care Reform / Q000266:history / Q000639:trends; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D010817:Physician-Patient Relations; D014481:United States