THE AMERICAN MEDICAL ASSOCIATION is growing feverish about them. A number of physicians who have joined up have found them toxic to their employment prospects. And many patient-clients are questioning the candor of their medical guidance. They are for-profit health-management organizations (HMOs). The aggravating agent is a clause in many HMO contracts, variously described by critics as a "loyalty oath" and a "gag rule," that forbids doctors to reveal certain sorts of information, including treatment options, to anyone, including their patients. The A.M.A. House of Delegates has ruled that such restrictions "are not in the best interests of patients and physicians.''
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