I think it is the last one
Well there could be problems with food, and if there is a sickness, or a desater, like flooding around you could not move on. Also the population can reduce food, and water.
Because the patients have to trust the medical professionals with their health and their life. One bad decision and it could make the patient really sick so it is very important for the patient and the medical doctor to have a trusted bond.
Hope this helps,
Davinia.