Physician-patient communication is not optimal. It suffers from an imbalance of information and power, misunderstandings and incomplete information transferred between the parties, and time constraints. Time constraints are due to patient volume, physician responsibilities, and explicit or implicit time restrictions imposed by patient insurers or physician employers. Communication is also complicated by a hesitancy to ask questions or give specific information, delays in accessing parties to transfer important information (usually, it is difficult to contact or recontact the physician), and poor communication skills. These difficulties do not universally exist among patients and clinicians—but are common enough to be discussed regularly in medical journals and in the popular media. Some of these problems are more frequently encountered in certain patient or physician subsets (e.g., certain medical specialties, practice locations, patient age groups, and cultural groups).