Despite the fact that older adults interact frequently with physicians, there is little research examining their preferences, and perceptions of the patient–physician relationship. Research on this topic is particularly sparse when it comes to older men. This study investigates older men’s experiences with physicians, their perceptions of the patient–physician relationship, and the extent to which they wished to be involved in their health care. In-depth, face-to-face interviews were conducted with 23 men 55–96 years of age. Findings reveal that older men want to participate in the medical encounter and be involved in their care, contradicting earlier work suggesting that older adults prefer to be passive patients. Preferred involvement, however, varied along a continuum ranging from “quasi-involvement” to “taking charge”, with most participants being in the middle, preferring a “partnership” patient–physician relationship. Factors influencing patient involvement and potential to negotiate the patient–physician relationship are discussed.