0
ARTICLE |

Bound to Gag

David U. Himmelstein, MD; Steffie Woolhandler, MD, MPH
Arch Intern Med. 1997;157(18):2033. doi:10.1001/archinte.1997.00440390015002.
Text Size: A A A
Published online

O WHAT physicians heard from patients was kept secret, scientists rushed to disclose discoveries, and ethicists criticized physicians for not telling patients the whole truth. Now insurance clerks routinely read medical charts, scientific breakthroughs are becoming trade secrets, and health maintenance organizations (HMOs) assert their right to tie our tongues.

The redefinitions of medical secrecy reflect and reinforce new commercial relationships that govern care. Physicians and scientists increasingly report to employers and insurers, who in turn answer to investors. Gag clauses make news because they too nakedly reveal who calls the shots in corporate care, contradicting the smoke screen rhetoric of market-driven accountability. Just as a car salesman works for the dealer, a gatekeeper works for the owner of the gate.

In this issue of the ARCHIVES, Brody and Bonham2 make the case that gag clauses are too raw a display of corporate power, and they are disturbed by

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs