I wish to respond to a Research Letter published in the Archives titled “Failure by Deans of Academic Medical Centers to Disclose Outside Income.”1 At the time the survey was conducted by Freshwater and Freshwater,1 I had 2 compensated activities outside of the university, in both cases serving on boards of highly reputable, publicly traded companies, OPKO Health Inc, Miami, Florida, and MEDNAX Inc, Sunrise, Florida. Each company provided me with cash compensation, which has been accurately reported ($10 000.00 and $60 000.00, respectively). In addition to this cash compensation and, as is the case for most publicly traded, for-profit companies, I also received stock options for serving on these boards whose exercise price (price I would have to pay to acquire the stock options) equaled the fair market value of the stock subject to the option on the date the option was granted. Stock options are not included in taxable income until exercised, and their spread value may materialize or not over an extended period. They should not and are not reported as income as far as the Internal Revenue Service is concerned until exercised.