Ruth (1998: 31) did a survey entitled “Medical Communication: Non-Native English Speaking Patients and Native English Speaking Professionals”. The instrument used for collecting data was a questionnaire. The results were that speaking was a key tool that they needed to call for cooperation among individuals in the delivery of health care services. The students health program and international students’ patients agreed on several problematic communication areas including medical vocabulary, mispronunciation, lack of confidence and pragmatic problems due to different procedural and cultural expectations. Additionally, each group mentioned problem areas, not being addressed by the other such as prejudice, manner of speaking, appropriate feedback and the effective value of a polite, and kind communicative approach. In summary, these problems fell into the areas of the content of the speech, the manner of speaking, pragmatic aspects of the interactions, and problems relating to different expectations and understanding of the American medical system.