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Abstract
Medical professionalism in her pool of definitions globally, has placed expectations of society and healthcare delivery. Ethics and patient-firstbeing foundation, Altruism has been the main element of medical professionalism. This omnipotent element,altruism, emerges from west. In a vulnerable and dynamic environment where values are been questioned and physicians being stressed to perform selflessly and raising question whether the real voice of the doctors and the patients have been heard and understood. Whether altruisms culturally stand relevant or should it be coexisting alongside of fiduciary relationship or by itself. This is in order to form more meaningful healthcare management based on applied ethics. This paper sociologically overviews the need for fiduciary relationship systematically.