Do patients need to follow the unwritten contract to "follow orders" as directed?

What do you mean "need to"? Of course they do, if they expect the treatment to go as well and as quickly as possible. If you can clarify why you are asking - or what the situation is, we may be able to help more specifically.

Well... for ex, if you are given antibiotics and directed to take it as scheduled until they are gone, and you don't, and then get sicker when the illness comes back meaner, whose fault is it?

Now, are you obligated to follow a docs advice? no. your body, your prerogative. My wife ignored her docs suggestion to have a hysterectomy to prevent painful adhesions. Two years of acupuncture and she's pain free... and I'm a daddy to a little boy. Thankfully in this case she didn't follow the prescribed regimen.

If you have doubts, see other opinions or alternatives. But if you stray, especially with meds, you are messing with your system without the proper knowledge to understand the ramifications.

As mentioned by rickj, what's the issue?

Yes, of course you need to follow doctor's advice. There are occasions like KPs that a second opinion is warranted, however, for the most part you need to follow the "care plan" of your doctor upon discharge.

I don't know your situation, but KP mentioned meds... This is very important especially if it is antibiotics. If the doc tells you to take it for 10 days and you stop taking it when you feel better, say 3 days, then you run the risk of becoming antibiotic resistant. This means that the next time you get the same illness then your body will need a much stronger antibiotic to kill the bacteria.

What type of doctor do I need to tell me what caused a scar?

Do you remember any injury to the area? A cut, scrape, bite? Even chickenpox?

I am not sure if a doc could telly you CAUSED a particular scar, but if so, the kind of doctor you would want to see would be a dermatologist.