This report examines the factors that influence researchers' abilities to recruit participants into health communication studies conducted within the clinical setting.Review of response rates over a 15 month data collection period for an intervention study on patient-physician communication, low health literacy, and diabetes management.Most patients were willing to participate (73%). The challenge was not fostering interest in the study, but rather being able to approach potential participants. Over the course of the study, patients with diabetes visited the clinic 1263 times yet interviewers were only able to approach patients 196 times for potential inclusion in the study. Confounding factors that affected recruiting participants included the interviewers' availability and clinic schedule, as well as patient chief complaint and no show or rescheduling rates.Researchers must engage in collaborative efforts with clinic staff during the research design phase, maximize their availability to approach potential patients, and capitalize on the insights of clinic staff to approach those patients who fit the study criteria and would be most willing to participate in the research project.Researchers must learn about the clinic, reduce research burden, and be flexible to work within the constraints of the clinic setting.