Doctor-patient exchanges in web counselling

Abstract

There are two overall approaches to doctor-patient interaction: the biomedical one and the socio-relational one. The biomedical approach is the most common and tends to explore the asymmetrical doctor-patient relationship. with the doctor seeking information about the patient’s complaints, giving a diagnosis and prescribing a treatment. The aim of this kind of communication is to create a good relationship in order to exchange information and facilitate treatment-related decisions. However, it is well-known that the production of talk is linked to the context. The relationship between doctor and patients can be performed online, through specific collaborative care service sites. It is still not known whether the new communication system offers new schemata in the interaction process: in online counselling, for example, there are no questions or interruptions (taken by doctors as a form of control; Ong, 1995, in Cordella, 2004) imposed on the patient. Online encounters are considered to have the potential of offering a new source of data. Comment entries concerning health issues can be seen as a doctor-patient interaction using a new channel that imposes new forms of interaction. These interactions must adapt the message, limited by the channel itself, displaying elements such as brevity, efficacy and clarity. By using an interactional sociolinguistic approach, the entry can be divided up into small units or episodes (Van Dijk, 1982; in Cordella, 2004) that share similarities, such as questioning, storytelling and help requests. This paper analyzes such discourse sequences and the use of particular communication strategies with the aim of understanding the nature of conversations between doctors and patients in online settings through the identification of recurrent patterns of communication. The theoretical framework is discourse and genre analysis (medical discourse, doctor-patient interaction and new media discourse) combined with studies on modalities, evidentiality and affect.