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This paper deals with a case study of a first visit of a person with hearing loss to her family doctor. In the first part of the paper, basic properties of doctor-patient interaction, which are also relevant for treatment of hearing loss, are outlined: the relevance of institutional conditions for interaction, asymmetries between the participants, goal-orientation, specific conditions of trust, and the relevance of the specific genre of doctor-patient interaction. The second part of the paper presents a case study, which focuses on three interactional phenomena: a) the negotiation of the hearing loss as an existential threat to the patient and her identity; b) the discrepancy of illness theories between doctor and patient; c) the collaborative work of negotiating an intersubjectively viable description of the experience of hearing loss.