Communication is critical to the outcome of all human interactions, including those between a doctor and patient, or a surgeon and healthcare team. It is one of the Royal Australasian College of Surgeons (RACS) nine competencies, originally developed with reference to the now revised CanMEDS roles. These provide a framework which assist assessment of performance in medical, thus surgical, practice. Whether a professional task involves a well-judged clinical decision, a challenging technical procedure or requires collaborative leadership and multidisciplinary input, good communication is required. Just as an ethical professional approach must consider the patient and their clinical problem, there is a need to communicate effectively with the patient, their family and with other health workers involved in their care. Otherwise, the decision and treatment offered may not match the patient’s values and goals, failing to achieve a shared understanding or, ultimately, compromising outcome. The modern surgeon also needs to respect the views of other health workers involved in the patient’s care.