A frequent complaint about the quality of health care delivery is that physicians often do not listen to their patients in consultation sessions. Studies indicate physicians show a tendency to listen only to patient discourse that the examiners had initiated, and to ignore questions and comments that the patients had initiated; that physicians argue with patients over the clinical meaning of descriptors used by patients; that physicians spent more time talking to infants rather than to the infants' mothers; and that the average physician spends very little total time listening to patients. Among the reasons cited for this lack of listening are the physicians' uncertainty about the diagnosis made, difficulty in listening to persons who do not share their level of medical expertise, or the impossibility of living up to the unrealistic expectations made by the patients. A communication course that could be built into the curricula of medical colleges should include such goals as (1) increasing the competencies the physician brings to the interview scene; (2) reducing feelings of threat; and (3) equipping the physician with techniques that allow the patient to solve the dilemmas that infuse the interview. (HOD)