The Dynamic Consultation: A Discourse Analytical Study Of Doctor-patient Communication (Pragmatics and Beyond New Series)

This book introduces a unique model of medical discourse that identifies the forms of talk – voices – that doctors and patients use during the consultation, and studies the dynamic interaction as it unfolds particularly in follow-up visits. Natural recordings, semi-structured interviews, questionnaires and ethnographic observations provide the data for the research, which was carried out in an Outpatient Clinic in Santiago, Chile. Using an interactional sociolinguistic approach, analysis of the data identifies doctor–patient communication as a micro-performance of broader socio-cultural realities, in which social status, power, knowledge and personal beliefs and values all find expression in the consultative setting. Importantly, while both doctor and patient voices are shown to contribute to an essentially asymmetrical exchange, the study also identifies the holistic and empathic Fellow Human voice, which places doctors and patients on a more equal footing. In connection with this voice, the Spanish concept of simpatía is also discussed. While the model in this study was developed within a specific socio-cultural framework, it is hoped that it will be adapted and modified more widely and contribute to a better understanding between doctors and their patients. This book introduces a unique model of medical discourse that identifies the forms of talk – voices – that doctors and patients use during the consultation, and studies the dynamic interaction as it unfolds particularly in follow-up visits. Natural recordings, semi-structured interviews, questionnaires and ethnographic observations provide the data for the research, which was carried out in an Outpatient Clinic in Santiago, Chile. Using an interactional sociolinguistic approach, analysis of the data identifies doctor–patient communication as a micro-performance of broader socio-cultural realities, in which social status, power, knowledge and personal beliefs and values all find expression in the consultative setting. Importantly, while both doctor and patient voices are shown to contribute to an essentially asymmetrical exchange, the study also identifies the holistic and empathic Fellow Human voice, which places doctors and patients on a more equal footing. In connection with this voice, the Spanish concept of simpatía is also discussed.While the model in this study was developed within a specific socio-cultural framework, it is hoped that it will be adapted and modified more widely and contribute to a better understanding between doctors and their patients. Ch. 1. Introduction -- Ch. 2. Discourse, Society And Doctor-patient Communication -- Ch. 3. Doctor-patient Communication : An Empirical Study -- Ch. 4. The Doctor Voice -- Ch. 5. The Educator Voice -- Ch. 6. The Fellow Human Voice -- Ch. 7. Patients' Voices -- Ch. 8. Patterns Of Footing -- Ch. 9. The Dynamic Consultation -- Ch. 10. Concluding Remarks -- App. 1. Approximate Total Word Count Of Doctors And Patients -- App. 2a. Patient Questionnaire (english Version) -- App. 2b. Patient Questionnaire (spanish Version) -- App. 3a. Doctor Questionnaire (english Version) -- App. 3b. Doctor Questionnaire (spanish Version) -- App. 4. Symbols Used In Discourse Transcriptions. Marisa Cordella. Includes Bibliographical References (p. [221]-234) And Index. Preface Acknowledgments 1. Introduction 2. Discourse, society and doctor-patient communication 3. Doctor-patient communication: An empirical study 4. The Doctor voice 5. The Educator voice 6. The Fellow Human voice 7. Patients' voice 8. Patterns of footing 9. The Dynamic Consultation 10. Concluding remarks Bibliography Appendices Index