A comparison of professional medical consultations and dramatized ones

Abstract

We present a multimodal study of dramatized medical consultations (cf. Turow, 2010), comparing them with actual medical consultations in relation to “patient-centred care” (Matthiessen, 2013; Slade et al., 2015). The breakthrough to scientific medicine starting around the 1830s led to the foregrounding of the “doctor’s gaze”, which is field-oriented, being concerned with expert diagnosis and treatment. The earlier reliance on information obtained in dialogue with the patient decreased in importance. But starting in the 1960s (e.g. Balint, 1969), practitioners have increasingly realized the fundamental importance of tenor considerations, including the use of interpersonal resources to enact rapport and empathy. This has been characterized as patient-centred care, and (in particular in long-term care situations) relationship-centred care (see Karimi, 2017), and the need for communication skills have come into focus (e.g. Kurtz, 2002). However, even though field goals and tenor goals complement one another and can be mutually supportive in medical consultations, there is still a tension between the two as far as doctors are concerned, and we will bring this out in our study of medical drama, House being a great example of a dramatic creation of a doctor who is grumpy (tenor: interpersonal) but brilliant (field: ideational), a kind of medical detective: Law (2017). Balint, Enid. 1969. “The possibilities of patient-centred medicine.” J.ROY. COLL. GEN. 17:269-276. Karimi, Neda. 2017. Patient-Centred Advanced Cancer Care: A Systemic Functional Linguistic Analysis of Oncology Consultations with Advanced Cancer Patients. Macquarie University: PhD thesis. Kurtz, Suzanne. 2002. “Doctor-patient communication: principles and practices.” Can. J.Neurol. Sci. 2002; 29: Suppl.: 23-29. Law, Locky Lok Hei. 2017. House M.D. and Creativity: A Corpus Linguistic Systemic Functional Multimodal Discourse Analysis Approach. The Hong Kong Polytechnic University: PhD thesis. Matthiessen, Christian M.I.M. 2013. “Applying Systemic Functional Linguistics in healthcare contexts.” Text and Talk 33(4-5): 437–466. Slade, Diana, Marie Manidis, Jeannette McGregor, Hermine Scheeres, Eloise Chandler, Jane Stein-Parbury, Roger Dunstan, Maria Herke & Christian M.I.M. Matthiessen. 2015. Communication in Hospital Emergency Departments. Berlin: Springer. Turow, Joseph. 2010. Playing doctor: television, story-telling & media power. Ann Arbor: The University of Michigan Press.