PubMed · 8007848
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G B Bluhm. 1994. Practice parameters. Physician input is key.. https://pubmed.ncbi.nlm.nih.gov/8007848/
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Gag rules-clauses in managed care contracts that prevent physicians from disclosing information that the plan may find disparaging, but that could relate directly to the patient's health-have recently been the subject of ethical condemnation and legislative prohibition. Another serious problem in managed care contracts, trade secrets, or guidelines and quality assurance mechanisms that are imposed on physicians while their origins are shrouded in proprietary secrecy, have by contrast received little attention. Responses to these ethical challenges to the physician's integrity must involve individual physicians, managed care organizations, professional organizations, and public policymakers.
When doctors launch their own managed care ventures, they soon find that cost control means care control. And in policing their own, they must resort to the techniques used by other health plans--gatekeepers and all.