In the present healthcare system, the physician directly involved in patient care faces developments that are difficult to reconcile with his daily medical activity. He must face that the free choice of a doctor is undermined by access restriction and regulation. The focus of his activity shifts from classical medical examination to documentation and administration of the patients. His professional freedom of action is reduced by economic constraints. The thinning of the political responsibility has the consequence that he is left alone in communicating negative developments to the patients. The culture of clinical research is also increasingly under the pressure of economic constraints. While it must be demanded that physicians adapt to new developments, this must not completely undermine the basic principles of the medical profession.