Excellent care is dependent on effective and meaningful communication between patients and their physicians. Communication is more than just the content: Process, relationship, and other systemic factors have a strong impact on the quality of this communication. Research suggests that as medical graduates progress through residency training, there is a decline in the quality of communication skills. One proposed reason for this unexpected decline is excessive focus on content of communication while neglecting relational, contextual, and systems influences on communication. This presentation from the 41st Forum for Behavioral Science in Medical Education explores how attachment theory can direct our thinking about communication and the doctor-patient relationship in primary care. For example, why do some residents struggle to maintain healthy boundaries with patients, while others do this easily? How can we build this important skill? Strategies for finding balance among content, process, and context in communication will be explored. Included in the slides is a tool to evaluate attachment style of medical learners.