© 2000 by Taylor and Francis Group, LLC. All rights reserved. This chapter considers properties of older patient-physician encounters in terms of the medical system and patients' and physicians' expectations. It focuses on the content and context of communication during geriatric encounters. Guidelines for the practice of geriatric medicine identify potential problems of older adults that should be integrated into clinical assessment for the optimal practice of medicine. M. E. Williams notes that a different perspective is needed for the medical evaluation of older patients. A. Beisecker summarizes studies about older patients indicating that physicians may show an age bias. Physicians frequently report problems with adherence as a source of frustration in communicating with patients. The general medical encounter can be viewed as an opportunity to create a good interpersonal relationship, exchange information, and negotiate treatment. The importance of the medical encounter in establishing understanding and priority for the treatment plan is underscored by a study of inadequate health literacy correlated independently with age and education.