The aim of this study was to explore the physician's communication pattern when breaking a bad unexpected news. 30 videotaped consultations (VRM) were collected in which the physicians met an actress as a patient. The doctors received the x-ray report in which an apical mass was detected before (condition A) or during (condition B) the consultation. The VRM were analysed through the Roter Interaction Analysis System (RIAS). Data suggested in condition B a significant decrease in "process", "counselling" and "emotional" categories. In consultation where a bad unexpected news is communicated doctors seem to be less directive in the content and more emotionally defended.