Nearly one in three doctors in the United States report withholding information from patients about useful medical services because they aren't covered by the patients' health insurance companies.

The authors of a new study say their work offers the first evidence for what many have long suspected: that coverage limitations imposed by managed care companies are infiltrating doctor-patient communications. “Patients aren't getting the whole story,” said Matthew Wynia, director of the Institute for Ethics at the American Medical Association and lead author of the study (Health Affairs 2003;22:190-7).

Dr Wynia and his …