As a practitioner working in the UK today we can expect to have a working life of maybe 45 years. This means that in full-time practice we are likely to engage in some 100 000 patient consultations throughout this period. Each one of these interactions will involve an individual communication process with our patient, which will be repeated many times each day. As with many professions (Casey and Wallis 2010; General Medical Council 2009), being able to communicate effectively is cited as one of our core competencies (General Optical Council 2011).