And the time constraints of managed care may discourage doctors from asking their diabetic patients how they're coping with the disease.

Some health plans have discouraged doctors from telling patients about expensive treatment options like bone marrow transplants.

Confidentiality, it argued, is needed to discourage doctors from hiding mistakes to save themselves professional or financial ruin.

The system is intended to discourage doctors from ordering expensive tests and procedures that may not be needed.

The proposal is intended to address the wide disparities in fees that are said to discourage doctors from going into family practice.

The need to pay off student loans discourages doctors from going to rural communities or inner-city hospitals.

Without a clear benefit, they said, even a small heart risk will discourage doctors from prescribing it.

But proponents of the new law said the warning was a scare tactic to discourage doctors from helping their patients.

The bill's broader effect would be to discourage doctors from giving appropriate pain relief to terminally ill patients.

"We want to find a way to get at financial incentives that discourage doctors from providing quality care," said Ms. Taylor.