By examining audio-recorded and transcribed, naturally occurring discourse data, this article shows how participants communicate involvement in two interpreter-mediated healthcare encounters. The article demonstrates how the relational exchange in these encounters, each involving a Swedish-speaking care provider, a young mother (one Spanish-speaking and one Russian-speaking) and a professionally trained interpreter, is affected by the way single participants orient to one another as conversational partners. The analysis also shows how primary participants’ orientation towards the interpreter as a conversational partner may have unexpected consequences for the interpreter’s degree of involvement and the participants’ control of conversational topics. Adding to previous studies of interpreter-mediated medical encounters explored as interaction (Wadensjö 1998), this article demonstrates the significance of shared and mutual focus between physicians and patients when it comes to building rapport and mutual trust across language barriers.