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To determine whether greater patient-reported symptom intensity and functional limitation influence expressed preferences for discretionary diagnostic and treatment interventions, we studied the association of patient factors and several Patient Reported Outcome Measure (PROM) scores with patient preferences for diagnostic and treatment interventions before and after the visit, a cross-sectional cohort study. One hundred and forty-three adult patients who completed several PROMs were asked their preferences for diagnostic and treatment interventions before and after a visit with an orthopedic surgeon. Patients with better physical function had fewer preferences for specific diagnostic interventions after the visit (P = .02), but PROM scores had no association with preferences for treatment interventions before or after the visit. A greater percentage of patients expressed the preference for no diagnostic or treatment intervention after the visit with a physician than before (diagnostic intervention; 2.1% before vs 30% after the visit; P ≤ .001 and treatment intervention; 2.1% before vs 17% after the visit; P ≤ .001). This study suggests that physician expertise may be more reassuring to people with more adaptive mind sets.