Over the past decade formal training in communication skills has become a prominent feature in the medical school curriculum. Yet patients still return from hospital outpatient clinics or from a spell on the wards with tales of doctors who are rude, patronising or simply incomprehensible. It seems that watching the ‘Breaking Bad News’ video has not improved many doctors' capacity to impart information — good or bad — or even taught some how to be civil. Indeed, despite all the talking and role-playing, and despite too the growing proportion of supposedly more empathic female doctors, the level of patients' dissatisfaction over their encounters with doctors appears to have increased. This is confirmed by the number …