The medical profession, along with a host of other groups, was seen as a threat by the Communists who through a variety of tactics not only undermined the profession but also devastated the entire health care system and its philosophy and ethics. Physician's salaries were so low (less than $100 per month) that most physicians were forced to chose between starving or accepting "gifts" from their patients. The "gift" system soon became a bribe system and devastated medical ethics as it is known in the West, including the patient-doctor relationship.

In the past, the people were taught that the responsibility for one's health was the State's and the doctor's, and therefore Romanians generally don't believe that they themselves are responsible for good health care habits. There is almost no awareness of the benefits of a healthy diet, or the dangers of smoking or alcohol.

Courses and materials emphasizing prevention of disease, early detection of disease, and patient education are just now being established in the curricula of some of the medical schools.

The existing limited health care dollars are spent (essentially wasted) at the hospital often without success on conditions which could have been prevented at the primary care level with patient education, prevention and earlier detection of disease, at a fraction of the cost.

Before WWII Romania also inherited from the French the philosophy known as polypharmacy (or prescribing the maximum number of medications rather than the minimum number of drugs felt to be necessary for a condition). This habit continues to be another source of ineffective, inefficient, and inappropriate use of Romania's health care dollars.