Strategies of linguistic politeness in routine gynecologic examinations

This study of linguistic politeness strategies in physician-patient communication analyzes selected transcripts of the naturally occurring speech between female patients and 16 experienced physicians--8 females and 8 males--who practice Obstetrics/Gynecology. The participants consented to being tape recorded during regularly scheduled appointments, either in the office of a private physician or in the university student health center gynecology clinic. Excerpts from a subsample of the appointments with private physicians provide an extraordinary opportunity to study the linguistic politeness during routine gynecologic examinations, including a breast exam.; This research characterizes the gynecologic examination as a situation with a high potential for face-threatening acts (FTAs), as defined by Brown and Levinson (1987) in Politeness: Some Universals in Language Usage. The basic inequality between physician and patient in terms of expert authority and interactional control, especially when the physician is male and the patient is female, contributes to the elevated potential for face threats in this medical encounter. The study demonstrates how ob/gyn physicians used strategies for conveying positive and negative politeness as they talked with patients during the gynecologic exam. Three patterns of topic management are shown to embody politeness strategies at the discourse level. One striking finding from the analysis of the interaction during the breast exams is the fact that the female physicians talked much less than did the male physicians directly about the breast exam and their findings. The male physicians also were more likely to remind patients about the importance of regular breast self-examination. One chapter discusses the issues involved with identifying and quantifying directives, a type of speech act that occurred frequently during the interactions recorded for this study.; This research describes an experience for females that has rarely been investigated. It contributes to the growing body of research on the function of talk in institutional settings and the ways in which talk in these settings differs from talk in ordinary casual conversations. It explores how politeness strategies operate to construct a subjective, non-sexual reality for both participants. It concludes with practical suggestions for improving physician-patient communication.