The season of goodwill provides the occasion to consider the importance of trust in facilitating social intercourse and a well functioning society.1 Trust provides the glue that makes cooperation possible without costly and intrusive regulation. Trust has declined in all social institutions in recent decades2 and medical leaders in the United States elicit as little public confidence as leaders in government and business.3 Trust in doctors has also diminished with the explosion of public information on betrayals of trust, failure to follow evidence based standards, and poor quality care, but patients remarkably retain much trust in their personal doctors.4 Such trust encourages sharing of intimate feelings, cooperation in treatment, and adherence to medical advice.5 Patients may have assimilated some of the negative media images of doctors and health organisations but they typically believe their doctor is different. Choosing one's doctor and care settings, continuity of care, and good …