Goodwill in the medical profession is severely strained after a year of being "treated so badly" by the Scottish Government, according to the head of a doctors' union.
The SNP administration's "unwillingness" to mitigate the impact of a UK Government decision to take more money from doctors' pay to put towards their pensions has "severely damaged trust amongst the medical profession", said British Medical Association chairman Dr Brian Keighley.
"This has been a really challenging year for the medical profession," he said in his end-of-year message. "Doctors' decision to even consider taking industrial action, up to and including a strike, reflects badly on any Government. Scottish ministers must recognise that the dispute over pensions has severely damaged trust amongst the medical profession.
"Continued attacks on doctors' terms and conditions have had a serious impact on workforce morale as doctors face a further year of pay freezes, increases to their pension contributions, at the same time as meeting rising demand for services with a shrinking workforce. There is only so much goodwill in the profession and at the moment it is severely strained.
"If Scottish ministers wish to continue the journey towards a quality NHS responsive to patients' needs, they will soon have to re-engage with the medical profession it has treated so badly in 2012.
"However, there are some encouraging signs that the Scottish Government is willing to listen. Ministers entered into negotiations with Scottish GP leaders to avoid the contract imposition being threatened elsewhere in the UK and have now agreed changes to the GP contract that recognise both the needs of patients and the need to manage workload in general practice."
A Scottish Government spokeswoman said: "Doctors play a crucial role in looking after our patients every day of the year, and we continue to work closely with the BMA on issues affecting its members in Scotland.
"In particular, reaching a negotiated settlement for the GP contract for next year will bring real benefits to patients, with GPs working more closely to help those patients most at risk of hospital admission.
"GPs will now provide extra care for those patients GPs judge to be most at risk of being admitted to hospital. This will improve the quality of care from the patient's perspective, promote integration of care and reduce both admissions and lengths of stay in hospital.
"In addition, we continue to be actively involved in pension discussions with the BMA and other NHS trade unions, and we will continue to work in partnership with them to find a way forward on pensions issues within the ever tighter constraints imposed on us by Westminster."