The last 30 years of technology-oriented medicine have shifted patients’ perception of the role of the physician. Before the explosion of technological medicine, the role of the physician was to cure, if possible, and to comfort. It was accepted that in many cases the physician would not be able to cure the disease. This was not a failing of the physician but a recognition that illness and death are an integral part of life. The shift to technology- oriented medicine helped to drive the growth of procedure-oriented specialty medical practice. This view of the physician as a skilled mechanic leads to an expectation of cure and to irreconcilable conflicts.

If the technological interventions offered fail, the physician fails because the supplementary role of comforter has been lost. Defensive medicine must perceptibly improve the outcome of care if it is to be an effective strategy. If it does not improve the patient’s perception of the outcome of the care, its negative impact on the humanistic aspects of care will engender patient dissatisfaction and hostility, resulting in an increase in litigation. In the worst case, it interferes with providing quality medical care: angering the patient and providing the grounds for a lawsuit.