Analyse the Discourse of Doctor-Patient Interaction: The Case of Gondar University Referral Hospital

Abstract

The study focused on Outpatient department of Gondar university teaching hospital, which is found in Gondar city. The main objective of this study is analyzing the discourse of doctor-patient interaction. Specifically, the study shows the actual interactional features in the doctor-patient interactions, the manifestations of power relations through language use, as well as the ideological assumptions which are held by doctors and patients. The qualitative data methods were used during data collection and analysis ,which was found from the interactions and field notes are useful to achieve these objectives. Purposeful sampling was used to select the OPD department where the study conducted. Data were gathered through audio-recording and field notes. The audio recordings last approximately eight to eleven minutes from each of the five analyzed medical interaction. Before analysis, the audio recordings were transcribed and then translated. The translated data were analyzed thoroughly using Fairclough’s (1992) three dimensional model of Critical Discourse Analysis. From the analysis, it was found out that the doctors are the dominant interlocutors in the interactions with patients. This dominance was seen in terms of different interactional control features that the doctors have employed. Thus, doctors’ institutional power is manifested in the way that they dominated the medical consultation in terms of turn allocation and repeated interruptions, initiating every exchange by asking questions, and controlling the topic and setting the agenda of the interaction. The patients, on the other hand, were mainly involved in reporting their symptoms, answering questions, and accepting doctors’ commands and/or requests. Thus, it was found out that the patients were the passive interlocutors. Additionally, a critical analysis of ideological assumptions doctors indicated that the doctors perceived themselves as the powerful interlocutors. The findings also showed that the patients saw themselves as the less powerful participants. Such was reflected through their submission to doctors’ authority, and by employing indirect and politeness strategies whenever they have to impose upon the doctors. The study, thus, concluded that interpersonal relationships between discourse interactants could be an indicative of their social and power relations. The study also recommended that a similar study focusing on other departments of the hospital can help to make generalization as to how institutional discourse, specially, that of doctor-patient, could be a place for power struggle.