In this paper, I draw on Goodwin's (1980, 1988, in press) research on directive-response speech sequences to examine how physicians formulate their directives to patients and how patients respond to those directives. My analysis of encounters between patients and family physicians indicates that women and men physicians issue their directives in dramatically different ways, and that their alternative formulations have consequences for patients' responses. Some directives are more likely than others to elicit compliant responses, and women physicians employ these more often than men do. In discussing these results, I consider their relationship to the issue of patient adherence more generally and to the quality of patients' relationships with women and men physicians.
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