How has the physician-patient relationship changed over the past century? Are the changes good or bad for the delivery of quality healthcare? Solution How has the physician-patient relationship changed over the past century? Rationing occurs when the physician decreases time spent with a patient, when decisions are made on withholding life support in terminal cases, and with regard to the availability of specialized equipment and specialized physicians. Are the changes good or bad for the delivery of quality healthcare? these are good because maximize savings, managed care has added new forms of rationing: rationing by delay, rationing by denial, and rationing by dilution .