Physician's explanations in multicultural primary care consultations
Keywords:
conversation analysis, doctor–patient interaction, explaining, Finnish as a second language, interactional linguistics, special vocabularyAbstract
In my data of multicultural primary care consultations, there are two types of asymmetry of knowledge between the physician and the patient. Firstly, the physician is an expert in the field of medicine and the patient is not, and secondly, the physician is a native Finnish speaker whereas the patient is an immigrant and speaks Finnish as a second language or communicates via an interpreter. Due to this, the use of medical terminology and other special vocabulary often requires explaining in order to be understood by the patient. In this article, I analyze 50 such explanations. I employ conversation analysis to examine explaining as an action in the context of primary care consultations, and interactional linguistics to analyze semantic, structural and lexical features of explanations.
In order to progress with the consultation, explanations are typically embedded in the on-going phase, such as giving the diagnosis or detailing treatment. The types and structures of the explanations vary. Some explanations are short (X i. e. Y), while others consist of several different structures (X is Y; X means that Y; X is linked to Y). The vocabulary used in the explanation turns is general, and the use of discourse markers that express uncertainty and indeterminacy (vähän niinku ‘a bit like’, semmonen ‘kind of ’, tavallaan ‘in a way’) is frequent. To make the explanations more understandable, physicians illustrate them with gestures. Instead of being precise, the aim of the explanations seems to be to provide the patients with practical information and to help them cope with their individual situation.
