A concordance-based study of metaphoric expressions used by general practitioners and patients in consultation.
BACKGROUND
All languages use metaphoric expressions; some deliberately chosen, some (for example, 'digesting information') not usually perceived as metaphoric. Increasingly, it is suggested metaphoric expressions constrain the way we conceptualise the world, as well as being a means of achieving stylistic effect.


OBJECTIVE
To study metaphoric expressions used by doctors and patients in general practice.


METHODS
Concordance-based language analysis of spoken data.


METHODS
A database containing transcriptions of 373 consultations with 40 doctors in a UK general practice setting was scrutinised for metaphoric expressions, using 'concordancing' software. Concordancing enables identification of strings of text with similar lexical properties. Comparators (for example, 'like'), selected verb-types (for example, of feeling), and the verb 'to be' were used as starting points for systematically exploring the data. Quantitative and qualitative thematic methods were used in analysis.


RESULTS
Doctors and patients use different metaphors. Doctors use mechanical metaphors to explain disease and speak of themselves as problem-solvers' and 'controllers of disease'. Patients employ a range of vivid metaphors, but fewer metaphors of machines and problem/solution. Patients use metaphors to describe symptoms and are more likely to use metaphoric language at the interface of physical and psychological symptoms ('tension, 'stress').


CONCLUSIONS
The different patterns of metaphoric expression suggest that doctors make limited attempts to enter the patients' conceptual world. This may not be a bad thing. One function of the consultation may be to reinterpret vivid and unique descriptions as accounts of the familiar and systemically comprehensible. Doctors may use different conceptual metaphors as a reassuring signal of expertise.
Skelton
John R
JR
Department of Primary Care and General Practice, University of Birmingham, Edgbaston. j.r.skelton@bham.ac.uk
Wearn
Andy M
AM
Hobbs
F D Richard
FD
D003142:Communication; D005194:Family Practice; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D019365:Metaphor; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology