There are many theories of meaning such as semantic theories (Rusellianism, fregeanism, Possible World Semantics, Davidsonianism, Internalist theories, etc and foundational theories of meaning (Gricean Program, interpretational theories, etc). Philosophers of language such as Russell, Frege, Grice, Davidson, and Chomskyan internalists have constructed theories of meaning by focusing on the following elements as meaning determiners: referent, property, thought, circumstances, truth-condition,

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... ention, language faculty, interpretation, causes, use, representations, and idea. None of these philosophers of language has thought of "speaker's need" which is the core element on which the above elements are based in order to state what determines meaning. Therefore, the objective of this article is to demonstrate how the perception of the speaker's need by the listener or hearer determines meaning in a linguistic communication. This demonstration is based on the results of a research conducted in Bonzola Hospital (a hospital in Mbujimayi City in Democratic Republic of Congo. The data in this study were collected through observation and interview. The observation consisted in attending the interaction between doctors and patients so as to listen to their utterances and watch their gestures, facial expressions, actions and whatever can occur during their communication. As far as the analysis of data is concerned, the Conversation Analysis was used so as to analyze the utterances, facial expressions, actions, gestures, and other elements that can occur in communication between doctors and patients. The results show clearly that the conveyance and reception of meaning does not depend mainly on referent, property, thought, circumstances, truth-condition, intention, language faculty, interpretation, causes, use, representations, and idea but the conveyance and reception of meaning depend on the perception of the speaker's need by the listener or hearer. The interpretation of the results led to the conclusion that meaning is determined by the perception of the speaker's need by the listener or hearer.