Before the Renaissance, citizens could identify the truth by referencing divine authority, particularly as articulated by God's representatives on earth. In the centuries after, truth could be guaranteed by applying scientific methods and the interpretations available through qualified scientists. For citizens, in general, the social contract that they enjoyed and to which they subscribed suggested that governing authorities spare them from cognitive dissonance by facilitating the availability of accurate and reliable information. In no area of life was this contractual function more explicit than about health. There were always civil agnostics who questioned the deal, but they were easily marginalised and ignored as ill-informed.

A feature of medical advice that made it distinctive was that it usually required action in the short term to prevent problems in the long term, which, to some extent, was speculative. Nevertheless, the majority of those receiving the advice accepted the need to boil water or take other sanitary precautions as well as availing of vaccinations. The marketing of advice was, to this extent, reliant on trust. This element of the response to medical science is weakening considerably. It is necessary, therefore, to understand the nature and characteristics of the new market for scientific advice as offered by professionally qualified medical personnel.

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