Blame managed care, says retired doc:

The time and money crunch basically brought about by managed care is a major driver in dwindling trust. Less time with the patient can only be bad. Missed or incorrect diagnoses for the individual patient impacted by it has to be one of the biggest trust busters possible. A hurried encounter with your doc leads only to the impression that he does not really care. A letter from your insurance company telling you your physician is delisted because he doesn’t meet the quality requirements may completely destroy trust even though the criteria used may be entirely bogus and born of cost control and not a tool to make your care better.