An Online Journal of Modern Philology ISSN 1214-5505

Sociolinguistic and Pragmatic Aspects of Doctor-Patient Communication (Book Review)


Markéta Johnová


The article reviews the book on Sociolinguistic and Pragmatic Aspects of Doctor-Patient Communication by Miroslav Černý, a study on the function of speech acts, use of medical terminology and manifestation of politeness in doctor-patient communication.

Černý, Miroslav, Sociolinguistic and Pragmatic Aspects of Doctor-Patient Communication Ostrava: Ostravská univerzita v Ostravě. Filozofická fakulta, 2007. ISBN 978-80-7368-250-7

We live in an age of the medicalization of the society – medical terms are used commonly in everyday discourse and medical topics have become a customary part of our conversations. All this brings about changes in the field of doctor-patient (D-P) interaction. Patients complain that the doctors are not willing to listen to them, do not answer their questions or inform them properly, they are authoritative and unhelpful. Doctors, on the other hand, criticize their patients for not following their advice. With his monograph Miroslav Černý reacts to this situation; he focuses on sociolinguistic and pragmatic aspects in D-P communication and shows that the social revolution has redefined the conventional roles within the medical encounter.

The corpus used for the analysis consists of approximately one hundred authentic face-to-face medical conversations from five different medical branches – Internal Medicine, Obstetrics and Gynaecology, Paediatrics, Oto-rhino-laryngology, and Orthopaedics, which allows the author to carry out a comparative analysis of D-P interviews in different medical settings. The conversations were taken from the book English for Doctors (ed. Mária Györffy 2001). The weakness of this material lies in the incompleteness of the analyzed dialogues, the lack of full social and sociolinguistic information about the participants of the interviews and the lack of tagging. To make up for the limitations of the first corpus and increase the degree of objectivity of the research material, Miroslav Černý used a second corpus of medical dialogues, taken from the book Manual of English for the Overseas Doctor (Joy Parkinson 2004).

The first aspect of D-P communication analyzed in the book is the function and the character of speech acts in D-P interaction. The author concisely examines the role of questions and methods of asking and then gives a thorough description of other speech acts and their sequential properties. As the theoretical background for this part of the books serves the speech act theory as proposed by Austin and further developed by Searle.

The significance of the use of medical terminology for the distribution of asymmetry in D-P interaction is the second aspect Miroslav Černý deals with in his book. The author shows how the social revolution has helped to balance the asymmetry between doctors and patients. This part of the analysis is particularly notable as there are very few studies on the same topic available.

The third part of the analysis explores the means of manifesting politeness in D-P communication, compares the productivity of negatively polite linguistic strategies from institutional settings (medical encounter) with those from non-institutional settings and presents a more detailed characterization of some aspects of D-P interaction (e.g. asymmetry vs. politeness).

By his analysis Miroslav Černý shows that D-P communication bears similarities to other institutional talks, but that there are many aspects that bring D-P talk close to everyday conversation. The great importance of the monograph lies in the fact that it captures the changes that the medical interviews have been undergoing in the recent years.

Nevertheless, Miroslav Černý’s research in the field of D-P interaction is not only of an outstanding linguistic value; it addresses students of medicine and their teachers as well as general practitioners. Its practical application is twofold. Firstly, it can serve as a concise handbook of medical English. Secondly, it represents an invaluable material for doctors and medical students who work in English speaking countries or with English speaking patients and who wish to learn more about the structure of medical interviews. Consequently, it can help to improve the process and delivery of medical treatment.

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