In Italy many people seem to distrust physicians. In order to understand this attitude it is necessary to turn to the branch of sociology that deals with the professions as well as to the studies on the systems of welfare. These instruments support the teory that both professional legitimacy and trust have been, in Italy more than in other countries, the result of individual and community relatantionships rather than of institutional instruments of social and scientific recognition. These are the fragile foundations on which a phisician-client relationship of the patron-client type has been built. This relationship was justified as long as italian society was characterised by very little state and market regulation, but when things changed, physicians were unable to find, inside the profession, the instruments necessary to renew the health pact, and chose the path of political or economic dominance. This is what people blame them for now.