Lékař mluví s pacientem.

Because the preposition s meaning with normally requires the instrumental case in Czech.

• basic form: pacient = patient
• instrumental singular: pacientem = with a patient / with the patient

So:

• s pacientem = with the patient/patient

This is one of the most important things to notice in the sentence: Czech changes noun endings depending on their role in the sentence.

The ending -em marks the instrumental singular of pacient.

In this sentence, it tells you that the patient is the person the doctor is speaking with.

A useful pattern is:

• student → studentem
• pacient → pacientem
• muž → mužem

So the ending often corresponds to English with + noun, although the instrumental case can be used in other situations too.

Mluví is the 3rd person singular present tense of the verb mluvit (to speak / to talk).

So it means:

• he speaks / she speaks / it speaks
• or in context, is speaking / is talking

Because the subject is lékař (doctor), the full meaning is:

• The doctor speaks / is speaking with the patient.

Czech present tense often covers both the simple present and the present progressive meanings that English separates.

It can mean both, depending on context.

Czech does not usually make a separate grammatical distinction like English does between:

• speaks
• is speaking

So mluví can be interpreted as either:

• a general present: The doctor speaks with the patient
• an action happening now: The doctor is speaking with the patient

The situation tells you which meaning is intended.

Czech has no articles like English a/an/the.

So lékař can mean:

• a doctor
• the doctor

and pacientem can mean:

• with a patient
• with the patient

Which one is meant depends on context.

This is very normal in Czech, and learners have to get used to understanding definiteness from the situation rather than from a separate word.

Yes. Czech word order is more flexible than English because the noun endings show grammatical relationships.

The neutral order here is:

• Lékař mluví s pacientem.

But you may also hear:

• S pacientem mluví lékař.
• Mluví lékař s pacientem.

These can sound different in emphasis, but the core meaning stays similar because:

• lékař is the subject
• s pacientem is the prepositional phrase

English relies much more on word order; Czech relies much more on endings and context.

A rough pronunciation is: LAY-karzh, but the last sound is the tricky Czech ř, which does not exist in English.

A few pronunciation notes:

• é is a long vowel, so lé- is longer than short e
• ř is a special Czech sound, something between r and zh
• stress in Czech is usually on the first syllable, so: LÉ-kař

If you cannot say ř yet, many learners start with something between r and zh. It will not be perfect, but it is a normal first step.

A careful pronunciation would be roughly:

• s pah-tsyen-tem

A few details:

• s here means with
• c in Czech is pronounced ts
• ie/ě-like sequences can make the consonant before them sound softer, so pacient is not pronounced like English patient
• -tem is pronounced clearly, with e as a normal Czech e

Also, in actual speech, the preposition s may sound more like z before a voiced consonant, so learners may hear something like z pacientem even though it is still written s pacientem.

Yes, lékař is a masculine noun.

If you want to refer specifically to a female doctor, Czech commonly uses:

• lékařka = female doctor

So you could say:

• Lékařka mluví s pacientem. = The female doctor is speaking with the patient.

However, in some contexts lékař may also be used more generally for the profession, especially in formal or generic statements.

Yes. Subject + verb + other information is a very common neutral order in Czech, just as in English.

So:

• Lékař = subject
• mluví = verb
• s pacientem = prepositional phrase

This makes Lékař mluví s pacientem a natural, straightforward sentence for learners.

Here s means with.

So:

• s pacientem = with the patient

Be careful, because Czech prepositions often require a specific case. With the meaning with, s usually takes the instrumental:

• s lékařem = with the doctor
• s pacientem = with the patient
• s kamarádem = with a friend

So it is useful to learn the preposition together with the case it requires.

Yes. That would also be correct.

• mluví is a common, everyday verb meaning speaks / talks
• hovoří also means speaks / talks, but often sounds a bit more formal

So:

• Lékař mluví s pacientem. = natural and common
• Lékař hovoří s pacientem. = also correct, somewhat more formal

Mluvit is imperfective.

That makes sense here, because present-tense forms of imperfective verbs can describe an action happening now or a general repeated action.

If you want a perfective partner, one common verb is:

• promluvit = to say a few words / to speak up / to speak once

But in ordinary sentences like this one, mluvit is the normal choice.

They are:

• lékař = doctor
• mluvit = to speak / to talk
• s = with
• pacient = patient

This is useful because when you look words up, Czech dictionaries usually list nouns in the nominative singular and verbs in the infinitive.

So even though the sentence contains mluví and pacientem, you would look up:

• mluvit
• pacient