To almost all of us, good health is a priceless asset; and the prominent role that communication plays has pushed effective medical interaction to a new level of importance. Subsequently, Fairclough (1992) stated “The main arena for medical interaction can be most comprehensively viewed in terms of the doctor-patient relationship (p. 143). The relationship between patients and doctors provides the foundations for establishing trust, rapport, and understanding, explaining diagnoses, and negotiating treatment. The ways doctors and patients use language to transfer their messages determine how the patient’s problem is understood, as well as shaping the relationship, which can have a healing value in its own right (Kevin, 2002). In this regard, even though, the practice of western medicine dates back to “…the time of King Libne Dengel (1520-1535), organized and sustainable modern medical practice started after the battle of Adwa (1896)” (Berhan, 2008, p.1). Still, little effort has been made in shading light on the medical interaction aspect of medical practice it deserved. Nevertheless, recently, little consideration has been given to it by different scholars.
For instance, Zewdnesh et al. (2009, p. 1) conducted a study to assess the behavior of physicians (verbal and non-verbal) when interacting with patients. Hence, their study has shown that there is reasonable ground to suggest that doctor-patient interaction has deficiencies. They suggested, “due attention should be given to improve communication skills of physicians”.
Additionally, Zewdie et al. (2009) undertook a study to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in ‘West Shoa’, Central Ethiopia. Even though their study was mainly conducted to asses satisfaction levels of patients, it was indicated that language and communication barriers were among the problems that were observed in the medical practices; hence, They specified that “perceived empathy, perceived technical competency, non-verbal communication, patient enablement and information sharing about the patient’s illness were the main predictor variables of patient satisfaction with health care provider interaction” (p, 10).
Furthermore, Abrham (2012) conducted a study in Kotebe Health Center. To the researcher’s knowledge, this is the only study that has tried to study the problem from a linguistics point of view. In this study, Abrham showed that there is miscommunication between doctors and patients. The reason is that both the doctor and the patient code switched from Amharic to English and vice versa. Additionally, the interlocutors (i.e. the doctor and the patient) used terminologies during medical interactions that have contributed for the miscommunication. He added, variables such as age, gender, educational status etc. have great impact in the interaction of the doctor and patient. Thus, one understands from the findings of the above researches that the doctor-patient interaction in the health care institutions in Ethiopia still requires further investigation and attention.
In addition to this, van Dijk (1995) wrote “…the institutional power holders may oblige participants to use specific language variant, to answer questions, to provide information, and to use a polite style. In all institutional communicative events such powers maybe abused or censored, intimidate or otherwise limit the freedom of less powerful participants” (p. 21). Thus, the future study will attempt to give a detailed linguistics and textual analysis in order to pinpoint the sometimes-subtle strategies of such forms of discursive dominance.
In addition to this, even though an effective doctor-patient interaction is central to building a therapeutic doctor-patient relationship which is important in the delivery of high-quality health care, researches in Ethiopia are still showing that the medical interaction aspect is not getting enough emphasis. Consequently, as Zewdie et al. (2009, p. 1) state “in primary health care, physician-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia”.
Thus, even though the aforementioned researches have tried to address the problem by taking a pragmatics and sociolinguistics perspective, I could not find any published, or unpublished study, which investigates doctor-patient interaction from a Critical Discourse Analysis point of view. Accordingly, the study will attempt to investigate doctor-patient interaction in Yekatit 12 Hopital by employing different linguistic theories so as to come up with a robust finding that will have a practical significance in many ways.