THE MORAL SCAFFOLDING OF REPUTATION: A PATIENT-CENTERED SCALE AND CRITICAL INQUIRY INTO THE PHYSICIAN-PATIENT RELATIONSHIP

A physicians reputation is more than an economic asset, it is a moral and relational construct, central to patient trust and the therapeutic covenant. While recognized as vital, its conceptualization remains medically reductionist, lacking a patient-centered hermeneutic. This study addresses this gap by developing a Physician Reputation Scale through a qualitative-quantitative mixed-methods approach, grounded in Rossiters (2002) paradigm.The resulting 14item framework reveals four dimensions,Medical Service, Human Qualities, Emotional Appeal, and Work Environment, illustrating that reputation is shaped not only by clinical competence but by affective and relational human factors. Notably absent was price sensitivity, underscoring the non-transactional nature of the clinical relationship.These findings offer a nuanced tool for humanizing healthcare evaluation. Yet they also surface deeper questions of ethical and structural import: How does reputation function under constrained agency? In underserved regions, where choice is limited, reputation may reflect necessity rather than virtue, raising critical concerns about equity, power, and the moral dimensions of care. This study thus invites a broader medical humanities discourse on how trust is constituted at the intersection of lived patient experience and systemic injustice.