Maintaining trust in the surgeon-patient relationship - Challenges for thenew millennium

Changes in the structure of the health care system have placed unprecedente d stress on the surgeon-patient relationship. The essential trust placed in the surgeon by her patients has been weakened by changes in the structure and financing of the health care system. This article considers the histori cal and ethical foundation of the surgeon-patient relationship and proposes that the primary moral obligation of surgeons is to strengthen and earn pa tient trust. By improving communication skills, enhancing ethical education , serving as consistent advocates for patients, and conducting patient-focu sed outcome research, the surgical community can meet its moral obligation by increasing trust in the surgeon-patient relationship.