Interpretation in doctor-patient interviews: a sociolinguistic analysis

Abstract

This paper discusses interpretation in doctor-patient interviews from a sociolinguistic perspective. A meaning-centered orientation to clinical practice calls for practitioners to create a clinical picture of the illness that is compatible with the patient's experience. This requires that appropriate interpretation of symptoms take place. Using transcripts of doctor-patient interviews, this paper demonstrates that another interpretive process, necessary to understanding illness, occurs at the level of conversation. Contrasting examples illustrate that without an adequate degree of "conversational cooperation," interpretation cannot take place. The results of poor conversational interpretation are the creation of an inaccurate clinical picture and the loss of clinically relevant information. The anthropological and sociolinguistic paradigms are linked by showing how differing perspectives on the illness affect conversational interpretation.