Grounding Patient Care Decisions: A Discourse Analysis of Doctor-Patient Interactions in Private Clinics

Abstract

This study draws from Grice’s conversational implicatures and uses Discourse Analysis to explore interactions of doctors and patients during consultations in private clinics. It advances the claim that effective use of communication strategies facilitates common ground as participants get involved in mutual discussion of treatment options, goals, and roles in health management. Extracts from eight transcripts of the audio-recorded interactions serve as data. Results show that communicative strategies of doctors include instances of bureaucratic negotiation and casual inserts, frequent repetitions and explanations, and codeswitching while patients preferred brief answers, asking for confirmation, and giving more information than requested. These strategies promote effective doctor-patient interaction and communication— central to doctors’ clinical competence and patients’ health status, satisfaction and health care.