Miscommunication between doctor and patient can affect the outcome of treatment and even lead to malpractice suits. The use of a computer by the doctor during medical service might affect communication or the doctor-patient relationship. The objectives of this study were to describe patient attitudes, to define the consequences of such attitudes on the doctor-patient relationship, and to describe patient expectations of doctors using computerized technology during outpatient medical service. This study was conducted during February 1-7, 2004. We used questionnaires to study the degree of disagreement and general ideas of 214 patients. Seven participants who disagreed were selected for a semi-structured interview. According to the questionnaire, about 20% of the patients disagreed with the use of a computer by the doctor during medical service. Three independent factors were related to this disagreement: sex, age group and type of service. Females were 2.3 times (95% CI = 1.2-4.4) more likely to be dissatisfied with the doctor's conversation, and 2.1 times (95% CI = 1.1-4.0) were likely to feel that the doctor listened to them less than when not using a computer. Older patients were more likely to be dissatisfied with their doctor's conversation than younger patients (OR = 2.8 (95% CI = 1.1-6.7). Participants from the outpatient department felt that doctors let them ask fewer questions than before compared to patients who had been admitted (OR = 2.5 (95% CI = 1.0- 6.1). The semi-structured interviews revealed that patients felt that nonverbal communications, such as attentiveness and eye contact from the doctor, were noticeably reduced when computers were used. It was also felt that the doctors talked less to the patient when using a computer compared to before the computerized system was adopted. Most of the participants were more concerned with the doctor's personality than with their competency, and none was concerned with confidentiality or legal issues. Even with these criticisms, however, all participants still agreed that in general the advantages of using a computer outweighed the disadvantages. It is concluded that, despite having a number of benefits for outpatient medical service, use of a computer can also lead to deteriorated communications and a poorer relationship between doctor and patient, and steps should be taken to address this problem.