We recently asked a group of critical care nurses and physicians how their work had changed over the past few years. We expected (and had steeled ourselves) to hear the litany of negative themes dominating the press of late: nursing shortages, daunting workloads, low reimbursement rates, poor morale, and a turbulent healthcare environment. None of these was mentioned. The number-one change they identified was a growing mistrust among patients and their families of caregivers. They explained that family members of patients hospitalized in the intensive care unit (ICU) took copious notes at the bedside, writing down nurses’ and doctors’ names and what each one did and said. They described patients who grilled each nurse about the nature and purpose of the medications that were being given and compared one set of answers to another. The nurses and physicians grieved for the time when patients and families trusted critical care professionals—trusted their competence, knowledge, and dedication—until proven unworthy of that trust. Today, it appears that our patients and their families mistrust until proven otherwise. What changes in the healthcare system have led to this erosion of confidence on the part of our patients and the public? We can think of four.