Constructive healthcare involves both physicians and patients as actively engaged communicators. A body of research has focused on the patient perspective with physician-patient consultations. The present qualitative study considered communication between physicians and patients. Information gathered from physicians presented a spectrum of patient communication behaviors that physicians find problematic, as well as physicians’ concerns about physician communication competency and needed training. The seven emerging themes included: patient preparedness and integrity, patient compliance/unrealistic goals and comprehension, language barriers and interpretation resources, internet consultation influences, communication skills training, cultural barriers and competency, and listening, empathy and time. The themes identified invite further examination of patient advocacy, intercultural interactions, online resources, empathy and listening in physician-patient relations. Results indicate that physicians recognize gaps in communication competency within their patient interactions which further supports the need for training.