Linguistic Accommodation in Medical Communication

Susan L Tamasi

Emory University, United States of America

Paper

This paper addresses the roles of language variation and linguistic accommodation within medical communication. Even though health communication research is a growing field in medicine, linguistics, and medical sociology, the effects of dialectal variation have previously been overlooked. However, research has found that inadequate or unsatisfactory physician-patient communication is the most common reason for low patient satisfaction and regularly leads to decreased patient compliance (Hagstrom 2004). In fact, Mischler (1984) goes so far as to say that the physician and patient actually have two distinctly different “voices” or discourse styles. Discrepancies in physician/patient communication not only lead to potential miscommunication, but they also reflect and maintain the social discrepancies between the two groups, especially with regard to status and education.

One strategy patients and physicians may use to promote better communication, which may also help to diminish such strong social differences, is through linguistic accommodation. For example, the physician may choose to use more general words instead of biomedical jargon. However, incorrect or overextended accommodation may be detrimental to the interaction. The use of more “simple” words by the physician could be viewed as condescending by the patient, or the incorrect use of medical terminology could lead the physician to perceive the patient as uneducated.

This paper reports on research conducted at a US public hospital which supports mostly minority and indigent patients. Eighty-six patient-participants were audio recorded as they met with a physician during scheduled clinic hours (approximately 20-45 minutes). The audio recordings were analyzed for use of phonological and morphological dialect features, with a focus on two minority dialects, African American English (AAE) and Southern American English (SAE), as well as the use of medical jargon. AAE and SAE are the varieties of English most commonly used by the patients at this particular hospital, but which are not generally used by the physicians.

Each physician/patient interaction was further examined for linguistic accommodation. The type of accommodation (phonological, lexical) was noted, as was the person who actively changed his/her speech (physician, patient, or both). Interactions were also coded for the direction of the accommodation (convergence or divergence). One interesting finding was that a few of the physicians would accommodate to the speech of their patients during one-on-one interactions, but would actually diverge and become more standard and use more medical jargon in front of another health care professional or when a patient’s family member was present.

References:

Hagstrom, Cynthia. 2004. “The Language of Doctors and Patients.” In Language in the USA, E. Finegan and J. R. Rickford, eds. Cambridge: Cambridge University Press. 445-462.

Mischler, Elliot G. 1984. The Discourse of Medicine: Dialectics of Medical Interviews. Norwood NJ: Ablex.

Session: Paper session
Language/medical 1
Thursday, April 3, 2008, 10:30-12:00
room: 07