The Dynamic Consultation: A discourse analytical study of doctor patient communication

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John Benjamins Publishing, Oct 13, 2004 - Language Arts & Disciplines - 254 pages
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.
 

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Contents

1 Introduction
1
2 Discourse society and doctorpatient communication
5
3 Doctorpatient communication
41
4 The Doctor voice
63
5 The Educator voice
87
6 The Fellow Human voice
121
7 Patients voices
149
8 Patterns of footing
185
9 The Dynamic Consultation
189
10 Concluding remarks
217
Bibliography
221
Appendices
235
Index
249
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