In this session we will seek to understand the challenges facing healthcare due to the loss of commitment to the ideals that guided physicians for more than 2,000 years. We will explore the historical framework of medicine as compared to today and evaluate the influence that change has had on the satisfaction of those receiving and providing care. We will contrast contracts and covenants as to how they impact availability and quality of care. We will look at the concept and practice of charity and care for the poor. And we will anticipate how these trends might affect the future of healthcare.