The idea for this special issue began with the panel, “Medical discourse in multicultural contexts: meeting doctor and patient concerns in secondary care”, organized by the co-editors for the 10th International Pragmatics Association Conference in Göteborg, Sweden in July 2007. In organizing the panel we pursued several interrelated aims. Having worked on a medical communication project for over a year by that time we were interested in establishing collaborative links with other researchers working in this field in the Asia region. Also, our main research interests evolved around examining multilingual and multicultural medical encounters. In our own project based in Hong Kong we were bewildered by the multitude of various issues that participants in the interactions had to deal with. These issues evolved around three “levels of remove” (Cameron and Williams 1997), or areas of disjuncture between patients and healthcare providers: medical, cultural and linguistic. Patients as well as medical professionals had to balance specialized medical knowledge with different levels of language proficiency as well as diverse sociocultural backgrounds.