Physician--Patient Communication as Interpersonal Rhetoric: A Narrative Approach

The medical interview is identified as a rhetorical situation in terms of its qualities of intentionality, strategy, relationship, and transaction. This article explores the ways in which patients and physicians shape their discourse in attempts to persuade, that is, gain cooperation from, one another. The accumulating literature on narrative theory, including that of Fisher, Donnelly, Cassell, Brody, and Kleinman, is reviewed as a promising rhetorical approach. Based on this body of theory, a narrative analysis of a doctor-patient encounter is used to demonstrate the utility of this perspective in interpreting and assessing the dynamics of the medical encounter as rhetoric. The methodology used is discussed in terms of generalizing its application to other medical interviews.