An Empirical Research On Pediatrician’s Discursive Identity Construction In Clinic Pediatric Doctor-patient Conversation

As is witnessed by Chinese people, the Chinese doctor-patient relationship has been deteriorating over the past decade. doctor-patient disputes occur frequently. This phenomenon has caused extensive academic concern. Although it can be attributed to many reasons, such as the problematic health care system, medical accidents. The poor doctor-patient communication is an extremely important cause of this phenomenon, especially the improper identities constructed by doctors. Though identities are not always constructed via language, humans do understand who they are to each other in discourse. In addition, discourse is also an arena on which ideology and power are enacted. On this account, the author of this thesis attempts to conduct an empirical study on the identities constructed by pediatricians in pediatric doctor-patient conversation. In this thesis, three research questions are addressed:(a) What identities are constructed by pediatricians in pediatric doctor-patient conversation?(b) What strategies are employed by pediatricians in the process of identity construction?(c) What ideologies are reflected in the different identities constructed by pediatricians?The data analyzed in this study were collected by the author in the clinic room of a hospital at Ankang City, Shaanxi Province with a Sony digital voice recorder, a total number of24conversations were recorded on8pediatricians (3recordings for each pediatrician), for the purpose of this project,8conversations are extracted(1for each pediatrician), transcribed, and approached within the integrated CA (conversation analysis)-CDA (critical discourse analysis) model. Methodologically speaking, a combination of quantitative and qualitative study is employed in this thesis.The analysis of the data indicates that five types of identities are constructed by pediatricians, namely, authoritative identity, care-taker identity, kinship identity, dominant identity, and fellow human identity. The first is evidenced by the constitution of the pediatricians’ turns and the actions accomplished by these turns, the distribution of question-raising between the pediatricians and the guardians (usually parents or grandparents) of the children patients, and the addressing forms adopted by them. The second is demonstrated by the pediatricians’strategy of turn design and the addressing forms employed by them to address the children patients. The third is mainly embodied in the addressing forms. The fourth is proved by the difference in process distribution and mood choice between the pediatricians and the guardians of children patients, and the modal resources utilized by the pediatricians. This type of identity is an embodiment of the Biomedical Model, in which the patient is regarded as a biological entity that is treated passively, with his or her emotional and psychological needs ignored. The fifth type of identity is realized by the politeness strategy and addressing forms. The influence of the Bio-Psycho-Social model can be traced in this type of identity; the patient’s emotional and psychological dimensions and subject position are focused on.The findings of this study lends evidence to the constructiveness of identity, furthermore, it can help raising doctor’s identity awareness and ameliorating the increasingly tense doctor-patient relationship. Additionally, the findings of this study can shed some light on medical ethics and medical sociology and provide guidance for doctor-training.