In addition, some HMOs actually prohibit their doctors from telling their patients about options that aren't available through the HMO. According to an article in Oncology Times (5/96 P22), "virtually all" HMOs have a "gag rule" in the contract between them and their doctors that discourages them from, "fully informing patients about options not included in their coverage." (Gag Rule - a clause written into too many Physician contracts that force the Doctor to remain silent about methods of care that are not provided by your insurance policy, even when that other method would be better for you.) The American Medical Association calls this practice "unethical" which it surely is. The contract between an HMO and its doctors is not a public document, so there's not even an easy way to tell if your HMO doctor is operating under a Gag Rule.
Given this, if you are an HMO patient, do not assume that you are getting the best treatment, or that you have been informed of all of your options. It is recommended that all HMO members have their treatment plan reviewed by an outside oncologist. You'll probably have to pay for the opinion yourself, but it's worth the expense. It is recommended that you get the opinion at a major cancer center or university hospital.
My Doctor Suggested I Participate In His Clinical Trial. Do I Need A Second Opinion?
If your doctor wants you to participate in a clinical trial that he is an investigator of, get a second opinion before signing up. One of the toughest things about running clinical trials is finding patients to participate. So the doctor may be putting his interests ahead of yours. Also, if you feel pressured or if your doctor seems to be coaxing you with "incentives" such as money, etc., get a second opinion. Another indicator that you need a second opinion is when your doctor makes comments about the "promise" of the clinical trial.Source: Cancerguide.org
