Item Details

Triadic medical interaction with a bilingual doctor

Issue: Vol 15 No. 2 (2018) Special Issue: Interpreter-Mediated Healthcare Encounters

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.31956

Abstract:

While studies of interpreted medical interactions are common, there is relatively little research on bilingual doctors who choose to consult in the migrant patients’ first language. This paper presents a case study of one such language concordant consultation conducted in Italian in the outpatients’ clinic of an Australian hospital, a triadic encounter where the patient was accompanied by her Italian-speaking daughter. In this consultation English medical terms were sometimes introduced but Italian was the main language of the consultation. The communication between all parties was notably very smooth and we reflect on reasons for this. These include the commitment of all parties to using Italian and the proactive role played by the patient’s Italian-speaking daughter in supporting and occasionally challenging her mother’s account of affairs. We conclude by reflecting on issues that bilingual doctors need to be aware of before undertaking to consult in more than one language.

Author: Louisa Willoughby, Marisa Cordella, Simon Musgrave, Julie Bradshaw

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References :

Adelman, R. D., Greene, M. G. and Charon, R. (1987) The physician-elderly patient-companion triad in the medical encounter: The development of a conceptual framework and research agenda. Gerontologist 27 (6): 729-734. doi:10.1093/geront/27.6.729.
https://doi.org/10.1093/geront/27.6.729

 

Baker, D. W., Hayes, R. and Fortier, J. P. (1998) Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Medical Care 36 (10): 1461-1470.
https://doi.org/10.1097/00005650-199810000-00004

 

Beisecker, A. E. (1989) The influence of a companion on the doctor-elderly patient interaction. Health Communication 1 (1): 55-70. doi:10.1207/s15327027hc0101_7
https://doi.org/10.1207/s15327027hc0101_7

 

Chao, M. T., Handley, M. A., Quan, J., Sarkar, U., Ratanawongsa, N. and Schillinger, D. (2015) Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes. Patient Education and Counseling 98 (11): 1360-1366. doi:10.1016/j.pec.2015.06.011.
https://doi.org/10.1016/j.pec.2015.06.011

 

Cordella, M. (2011a) Enfrentándose Al Cáncer En Compañía: El Rol Del Familiar En La Consulta. Discurso & Sociedad 5 (3): 469-491.

 

Cordella, M. (2011b) A triangle that may work well: Looking through the angles of a three-way exchange in cancer medical encounters. Discourse & Communication 5 (4): 337-353. doi:10.1177/1750481311418100.
https://doi.org/10.1177/1750481311418100

 

Cordella, M., and Poiani, A. (2014) Behavioural Oncology: Psychological, Communicative and Social Dimensions. New York: Springer.
https://doi.org/10.1007/978-1-4614-9605-2

 

Coupland, N. and Coupland, J. (2000) Relational frames and pronominal address/reference: The discourse of geriatric medical triads. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 207-229. London: Pearson.

 

Du Bois, J. W. S., Schuetze-Coburn, S., Cumming, S. and Paolino, D. (1993) Outline of discourse transcription. In J. Edwards and M. Lampert (eds) Talking Data: Transcription and Coding in Discourse Research, 45-89. Hillsdale, NJ: Lawrence Erlbaum Associates.

 

Dunlap, J. L., Jaramillo, J. D., Koppolu, R., Wright, R., Mendoza, F. and Bruzoni, M. (2015) The effects of language concordant care on patient satisfaction and clinical understanding for Hispanic pediatric surgery patients. Journal of Pediatric Surgery 50 (9): 1586-1589. doi:10.1016/j.jpedsurg.2014.12.020.
https://doi.org/10.1016/j.jpedsurg.2014.12.020

 

Fernandez, A., Schillinger, D., Grumbach, K., Rosenthal, A., Stewart, A. L., Wang, F. and Pérez-Stable, E. J. (2004) Physician Language Ability and Cultural Competence. Journal of General Internal Medicine 19 (2): 167-174. doi:10.1111/j.1525-1497.2004.30266.x.
https://doi.org/10.1111/j.1525-1497.2004.30266.x

 

Gordon, H. S., Street, R. L., Sharf, B. F. and Souchek, J. (2006) Racial differences in doctors’ information-giving and patients’ participation. Cancer 107 (6): 1313-1320. doi:10.1002/cncr.22122.
https://doi.org/10.1002/cncr.22122

 

Green, A. R, Ngo-Metzger, Q., Legedza, A. T. R., Massagli, M. P., Phillips, R. S. and Iezzoni, L. I. (2005) Interpreter services, language concordance, and health care quality. Journal of General Internal Medicine 20 (11): 1050-1056. doi:10.1111/j.1525-1497.2005.0223.x.
https://doi.org/10.1111/j.1525-1497.2005.0223.x

 

Hampers, L. C. and McNulty, J. E. (2002) Professional interpreters and bilingual physicians in a pediatric emergency department: Effect on resource utilization. Archives of Pediatrics & Adolescent Medicine 156 (11): 1108-1113. doi:10.1001/archpedi.156.11.1108
https://doi.org/10.1001/archpedi.156.11.1108

 

Lee, L. J., Batal, H. A., Maselli, J. H. and Kutner, J. S. (2002) Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic. Journal of General Internal Medicine 17 (8): 641-646. doi:10.1046/j.1525-1497.2002.10742.x.
https://doi.org/10.1046/j.1525-1497.2002.10742.x

 

Lienard, A., Merckaert, I., Libert, Y., Delvaux, N., Marchal, S., Boniver, J. Etienne, A. M., Klastersky, J., Reynaert, C., Scalliet, P., Slachmuylder, J. L., Razavi, D. (2008) Factors that influence cancer patients’ and relatives’ anxiety following a three-person medical consultation: Impact of a communication skills training program for physicians. Psycho-Oncology 17 (5): 488-496. doi:10.1002/pon.1262.
https://doi.org/10.1002/pon.1262

 

Masland, M. C., Kang, S. H. and Ma, Y. (2011) Association between limited English proficiency and understanding prescription labels among five ethnic groups in California. Ethnicity & Health 16 (2): 125-144. doi:10.1080/13557858.2010.543950.
https://doi.org/10.1080/13557858.2010.543950

 

Mitchell, J. (1984). Typicality and the case study. In R. Ellen (ed.) Ethnographic Research: A Guide to General Conduct, 237-241. London: Academic Press.

 

Ngo-Metzger, Q., Sorkin, D. H., Phillips, R. S., Greenfield, S., Massagli, M. P., Clarridge, B. and Kaplan, S. H. (2007) Providing high-quality care for limited English proficient patients: The importance of language concordance and interpreter use. Journal of General Internal Medicine 22 (suppl. 2): 324-330. doi:10.1007/s11606-007-0340-z.
https://doi.org/10.1007/s11606-007-0340-z

 

O’Brien, M. and Shea, J. (2011) Disparities in patient satisfaction among Hispanics: The role of language preference. Journal of Immigrant and Minority Health / Center for Minority Public Health 13 (2): 408-412. doi:10.1007/s10903-009-9275-2.
https://doi.org/10.1007/s10903-009-9275-2

 

Risteen Hasselkus, B. (1994) Three-track care: Older patient, family member, and physician in the medical visit. Journal of Aging Studies 8 (3): 291-307. doi:10.1016/0890-4065(94)90005-1
https://doi.org/10.1016/0890-4065(94)90005-1

 

Street, R. L and Gordon, H. S. (2008) Companion participation in cancer consultations. Psycho-Oncology 17 (3): 244-251. doi:10.1002/pon.1225
https://doi.org/10.1002/pon.1225

 

Sudore, R. L., Landefeld, C. S., Pérez-Stable, E. J., Bibbins-Domingo, K., Williams, B. A. and Schillinger, D. (2009) Unraveling the relationship between literacy, language proficiency, and patient-physician communication. Patient Education and Counseling 75 (3): 398-402. doi:10.1016/j.pec.2009.02.019
https://doi.org/10.1016/j.pec.2009.02.019

 

Tates, K. and Meeuwesen, L. (2001) Doctor-parent-child communication: A (re)view of the literature. Social Science & Medicine 52 (6): 839-851. doi:10.1016/S0277-9536(00)00193-3.
https://doi.org/10.1016/S0277-9536(00)00193-3

 

Tsai, M. (2007) Who gets to talk? An alternative framework evaluating companion effects in geriatric triads. Communication & Medicine 4 (1): 37-49. doi:10.1515/CAM.2007.005
https://doi.org/10.1515/CAM.2007.005

 

Vertovec, S. (2007) Super-diversity and its implications. Ethnic and Racial Studies 30 (6): 1024-1054. doi:10.1080/01419870701599465
https://doi.org/10.1080/01419870701599465

 

Vickers, C. H., Goble, R. and Deckert, S. K. (2015) Third party interaction in the medical context: Code-switching and control. Journal of Pragmatics 84: 154-171. doi:10.1016/j.pragma.2015.05.009.
https://doi.org/10.1016/j.pragma.2015.05.009

 

Willoughby, L., Musgrave, S., Cordella, M. and Bradshaw, J. (2015) Being heard: The role of family members in bilingual medical consultations. In E. Stracke (ed.) Intersections: Applied Linguistics as a Meeting Place, 22-42. Newcastle upon Tyne: Cambridge Scholars Publishing.

 

Wilson, E., Alice H. C., Grumbach, K., Wang, F. and Fernandez, A. (2005) Effects of limited English proficiency and physician language on health care comprehension. Journal of General Internal Medicine 20 (9): 800-806. doi:10.1111/j.1525-1497.2005.0174.x
https://doi.org/10.1111/j.1525-1497.2005.0174.x

 

Yoon, J., Grumbach, K. and Bindman, A. B. (2004) Access to Spanish-speaking physicians in California: Supply, insurance, or both. Journal of the American Board of Family Practice 17 (3): 165-72. doi:10.3122/jabfm.17.3.165
https://doi.org/10.3122/jabfm.17.3.165