More and more employer-based insurance plans are using incentives and penalties to encourage healthy lifestyle choices among those they insure. Sometimes these wellness programs employ "carrots" and "sticks" that limit benefits or charge more for coverage. A company benefits representative, health insurance executive, and a physician discuss the new trend in wellness programs and how they affect patients, the patient-physician relationship, and employers. To read about this dilemma in detail, see the November 2008 issue of Virtual Mentor at www.journalofethics.org.