Honesty may be the best policy, but when delivering bad news to patients, physicians must prepare to pay a price for that honesty. You simply do not like the doctor who tells you what you are afraid to hear. In this age of greater accountability in health care, the satisfaction of patients and the subtle nuance of likeability is connected directly to doctor payment. And patients who don't like what their doctor tells them won't "like" that doctor on the growing number of physician rating services springing up on the Internet. The complex task of adding unwelcome and difficult content to a conversation may impede physicians from having dialogues about the most sensitive issues.