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.
Table of contents
1. Introduction 1–3
2. Discourse, society and doctor-patient communication 5–40
3. Doctor-patient communication: An empirical study 41–62
4. The Doctor voice 63–86
5. The Educator voice 87–119
6. The Fellow Human voice 121–148
7. Patients' voice 149–183
8. Patterns of footing 185–188
9. The Dynamic Consultation 189–216
10. Concluding remarks 217–219