Patient-provider communication is critical to eliminating disparities in healthcare. Both the patient and the physician bring a variety of assumptions to the therapeutic partnership. As illustrated in a surgical case, these are based not only on race and ethnicity but also on a host of other factors, which may affect both partners' perceptions of reality and their subsequent behavior. Communication is an essential component of quality and is necessary to improve patients' understanding of the content of their care, their ability to make informed choices, and their ability to adhere to recommended therapies. There are a variety of practical strategies to enhance awareness of these issues and improve communication that we need to begin to incorporate into surgical culture.