An implantable medical device system includes an implanted device communicating with an external device via telemetry. The implanted device and the external device each have a telemetry module connected to an antenna system to support a radio-frequency (RF) telemetry link. The antenna system of the external device has a manually or automatically controllable directionality. The controllable directionality is achieved, for example, by using two or more directional antennas, one non-directional antenna and one or more directional antennas, or an electronically steerable phased-array directional antenna.