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Insights Into Medical Communication

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Edited By Maurizio Gotti, Stefania Maria Maci and Michele Sala

This book analyses the subject of medical communication from a range of innovative perspectives, covering a broad spectrum of approaches and procedures that are particularly significant in this field.
In this volume, medical communication is analyzed from various viewpoints: not only from a merely linguistic angle, with a focus on the description of the genres used in medical and healthcare contexts, but also from a social and cultural standpoint, with an emphasis both on the doctor-patient relationship and on the social relevance of the other types of communicative links existing between the many communities involved in this type of interaction.
The study of some of the main fields typical of medical communication has highlighted a considerable variety of themes, data and research methods which are clearly representative of the eclectic interest in this specific domain and of the wide range of approaches developed for its investigation.
As the various chapters show, linguistic analysis proves to be highly applicable to textualizations involving multiple interactions and practices, and several kinds of participants, including different healthcare professionals, trainees and patients.
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Dialectal Variation and Miscommunication in Medical Discourse: A Case Study

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1.  Introduction

This study explores the case of a minority English-speaking patient who was misdiagnosed with mental illness, leaving her actual neurological illness, Stiff Person Syndrome (SPS), unobserved for over ten years. We hypothesize: 1) that this patient’s minority-affiliated speech variant, African American Vernacular English (AAVE), contributed to her being misdiagnosed – by multiple doctors – for a decade, 2) that dialect discord in general can both influence how a physician conceptualizes the symptoms of a patient, and exacerbate the ambiguity that can occur when describing symptoms, and 3) that medical school training may emphasize limited lexical cues that often vary from actual patient descriptions. We explore an interface of linguistic variation and unconscious bias against unfairly stigmatized language variants, as a cause of misdiagnosis, such that, for example, written records of patient descriptions, which are not phonetic, may even reduce some of the communication barrier. Extant research on doctor-patient communication primarily focuses on successfully conveying information to the patient, making this chapter a step toward filling a gap in the literature on doctors misunderstanding patient descriptions of symptoms, and, on doctor-patient dialect discord.

This study includes: a working definition of language variation and sociolects in §2; a review of the literature on dialect discord and stigmatization in §3; the medical details of the case study, a discussion of some medical training words associated with SPS, and a retrospective medical chart review with doctor reports of the patient’s descriptions throughout the period of misdiagnosis, in §4;...

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