Receptionists who work in government health facilities in Kenya are part of large state funded ministry, the Ministry of Medical Services. Their counterparts who work in private hospitals fall under the hospital management, the human resource department. Private hospitals in Kenya are represented by the Kenya healthcare federation. Their (receptionists) duties include registering patients, arranging appointments for them and checking them for consultations as well as administration of the ordering and collection of repeat prescriptions. This paper therefore analsysed transactional patterns used by receptionists and patients in their enactment of their different roles and identities. The data analysis is based on Goffman’s (2002) roles and identities and Kaspar’s (2000) power models. The study uses both primary and secondary sources that involve audio data recorded at the one government health facility and one private health facility, and extensive library research. Purposive sampling is used to sample the two health facilities in Nyanza. Data from naturally occurring conversations among the receptionists and the patients is analysed using the qualitative research design. It is therefore proposed that the findings from this study be used in receptionist training programmes to raise awareness of patterns of discourse behaviour at the front desk discourse with a view to improving both the professional experience of receptionists and the quality of service which patients at government health facilities and private health facilities receive. Quality customer service is equivalent of vision 2030’s social pillar, which rests on the premise that investment in human capital is paramount for economic development