title: The lost art of the covenant: trust as a commodity in health care.
abstract: Physicians argue that the advent of managed care has turned medicine into a business and that they spend more time learning the art of doing business than practicing medicine, while losing their professional spirit, patient loyalty, autonomy, and income. Medicine was a business before it was a science. Holding on to Hippocratic ideals in a world of on-demand consumers has made the covenantal physician-patient relationship ineffective and devoid of mutual trust. Physicians have argued that trust is time-dependent and a casualty of time-bound managed care guidelines. The author suggests that the principle of trust is not outdated, not exclusively time-dependent, and is still relevant to a modern Hippocrates loyalist. A relationship of trust is built on the style and quality of verbal and nonverbal communication. Trust is not an acquired trait; it is an expectation resulting from an interactive process of human concern and caring.
authors.affiliation: College of Health and Social Services, New Mexico State University, Las Cruces, NM. jgbruhn@azlink.com
authors.forename: John G
authors.initials: JG
authors.lastname: Bruhn
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D008329:Managed Care Programs; D010817:Physician-Patient Relations; D035502:Trust; D014481:United States