Noting that interaction between patients and health care providers is a critical factor in the delivery of medical care, this paper argues that an interpersonal perspective can and should provide the paradigm for the study of medical communication. It suggests that the relationship between the sociocultural context in health care and communication can be described in terms of four interrelated levels of context--cultural, socioinstitutional, functional, and situational. The discussion of these interrelated levels of contexts indicates that health care communication research should proceed in four directions: (1) determining how the socialization process in medicine influences individual beliefs about the nature, function, and value of communication; (2) providing an understanding of how the role systems in health care facilitate and constrain communication competence by orienting individuals toward certain modes of interpersonal behavior; (3) explicating the functions by which language has evolved in the health care arena through an examination of the goals, barriers, and strategies within the regulative, interpersonal, identity, and instructional contexts; and (4) focusing on how the social ecology of particular health care situations, the situated beliefs of social actors, and the sense of social structure that emerges in interaction together influence interpersonal behavior. (Author/RL)