Discursive strategies for addressing patients’ disalignment with diagnosis in online medical consultations in China

Abstract

While online medical consultations (OMCs) have become increasingly popular, not least in times when epidemics make access to medical facilities difficult, research exploring the interactive value of OMC is still in its infancy. This study examines patients’ disalignment with speculative diagnosis and its management by doctors in OMC interactions, which to my best knowledge are not examined. From a discourse analytic perspective, this study adopts Du Bois’s notion of stance-taking to approach text-based interactions collected from a widely used OMC website in China. This study finds that patients’ disalignment is often based on hard evidence, which is different from the major findings of previous studies. When addressing such disalignment, doctors adopt varied discursive strategies, which are hardly mentioned in prior studies, in particular, strategies that address the affective aspect of patients’ disalignment. This study thus provides a different perspective on disalignment and its management in the clinical context.

Online Physician-Patient Interaction and Patient Satisfaction: Empirical Study of the Internet Hospital Service

“…Responsiveness is a central dimension of service quality, especially in service delivery [46]. Responsiveness refers to both the speed of response throughout the physician-patient interaction [47][48][49] and the extent of attentive and individualized service delivered [50][51][52].…”

“…Sometimes physicians provide emotional support when patients are anxious [46]. In a comfortable interaction, physicians demonstrate their humanity and friendly attitude rather than working as a cold answering machine.…”

“…Patients anticipate receiving assistance with medical information as well as anxiety reduction [57]. Expressions of empathy, such as emotional comfort, imply that physicians care about their patients' feelings and needs [46,58]. Patients also associate empathy with reassurance and the provision of medical information, and it can boost patients' optimism in the face of illness and promote trust in the physician-patient relationship [59].…”