This article studies the coordination of patients' production of their primary complaint and doctors' orientation to the patient on the one hand and to medical records on the other. In specific environments the doctor's shift of focus from interaction with the patient towards reading or writing the medical records is received by the patients as problematic. It is suggested that disengaging from interaction and engaging in studying the medical records may leave the patient puzzled about whether the doctor is listening or not. Thus, paying attention to the coordination and timing of these shifts in orientation may help the doctors to develop more patient-centered ways of interacting with the patient. Furthermore, studying the coordination of verbal and non-verbal aspects in medical interaction may complement the current ideas on the constituents of the ideal model of 'patient-centeredness' in medical interaction.