The interpersonal relationship between physician and patient involves a highly charged affective component. As a result, patients' satisfaction with medical care, their compliance with treatment regimens, and the outcome of treatment tend to be substantially related to their physicians' ability to satisfy their socio-emotional needs in the health care encounter. This critical aspect of health care is termed “rapport.” While it is not yet clear exactly how rapport with patients can be achieved, evidence reviewed here suggests that a physician's ability to establish rapport with patients is at least partially dependent upon his or her communication skills, especially the ability to decode and encode nonverbal messages of affect. Implications for teaching physicians the elements of empathic communication are discussed.