Rationale, aims and objectives Patient-physician communication is the mainstay of successful medical practice. To assess knowledge, attitude, and practice of surgeons and Intensive Care Unit (ICU) physicians about key elements of informed decision-making communication. Methods A multicenter, cross-sectional survey among surgeons, ICU physicians, patients and patient’s relatives in Bangladesh, Egypt, Iraq, and Vietnam was conducted using convenience sampling. Two self-completed questionnaires were dedicated to the survey members. Results While doctors acquire a good level of knowledge and have a positive attitude toward informed decision-making communication, the applying practice level is low although the correlations between knowledge, attitude and practice are strong. The fulfillment of patients’ expectation was lower among those who did not meet their doctors before and after treatment/surgery, had to pay for their treatments or had high education level. Conclusions The gap between knowledge and practice in doctor-patient communication is highlighted. The patient’s experience toward communication with doctor varies among different groups of age, chance to meet with doctor, and payment required.