title: Discourse analysis and the doctor-patient relationship.
abstract: This article describes a system of discourse analysis, called a "taxonomy of verbal response modes," which can be applied to medical interviews. The taxonomy identifies eight basic categories: disclosure, question, edification, acknowledgement, advisement, interpretation, confirmation, and reflection, which are defined by three principles of classification. The categories are mutually exclusive and exhaustive. Each mode conveys a particular interpersonal intent and also has a characteristic grammatical form. With eight forms and eight intents, the taxonomy includes sixty-four possible verbal response modes, eight "pure modes," in which form and intent coincide, and fifty-six "mixed modes," in which form and intent differ. The taxonomy has yielded fine-grained descriptions of patient-physician interaction and has identified particular types of utterances and verbal exchanges that are associated with patients' satisfaction with their medical interviews. The system provides a detailed descriptive vocabulary that may be useful for teaching interviewing skills.
mesh_terms: D006801:Humans; D008487:Medical History Taking; D010808:Physical Examination; D010817:Physician-Patient Relations; D012660:Semantics; D014705:Verbal Behavior