Traditionally, physician-patient communication seems to have centered on telling the patient what the physician felt the patient needed to know, and the physician telling the patient what to do. This model is being challenged on a number of fronts. Berwick (2003) has challenged the whole way of traditionally “doing medicine” – from the point of view of safety. Groopman (2003) has discussed the scientific foundations and place of hope in medical treatment. We will propose a model of communication that takes the above into consideration. We will consider physician-patient communication not only from the cognitive but also the affective dimension. The model will provide a framework within which to design and implement physician/patient interaction. The model will extend other conversational models, e.g., those proposed by Winograd (1987) and Divitini and Simone (2001). Extensions for other health care workers will be considered, as will implications for safety and overall health.