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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Alexander and colleagues¹ found that 63% of patients reported a desire to talk about out-of-pocket expenses with their physicians and that 79% of physicians believed that patients wanted to discuss these costs. Only 35% of physicians and 15% of patients, however, recalled ever having discussed out-of-pocket expenses during a consultation.

This disparity was a predictable result of the way that these preferences were derived. The authors compared stated preferences (what individuals say they want) with revealed preferences (what individuals actually choose to do).² These 2 types of preferences would be expected to differ because an individual's desires are often limitless while their choices are limited by many different constraints (in this case patient-physician communication is limited by time).³ For example, a physician and patient may want to discuss many things, but they have to prioritize items for discussion because of time constraints.

It would have been . . . [Full Text of this Article]

John F. P. Bridges, PhD
Department of Epidemiology and Biostatistics
Case Western Reserve University
School of Medicine
Cleveland, Ohio

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