2013 Volume 16 Issue 1 Pages 80-95
Little is known about the relationship between asymmetry in doctor-patient communication and the influence of culture. This study used qualitative and quantitative discourse analysis to compare 20 outpatient consultations in Japan with 20 in the US. The main outcomes examined were activity structures and linguistic variations when beginning and closing the consultations, and in the question and answer time between the doctors and patients. Compared with America, the Japanese consultations tended to show 1. more succinct structures, more ambiguous brackets and more asymmetrical exchanges in the beginning, 2. more supportive/dependent and asymmetrical exchanges (by cooperative turn sequences and back-channeling) in the question and answer time, and 3. more institutionalized and asymmetrical exchanges when closing the consultation. These asymmetrical variations, which may reflect high-context and relation-based Japanese culture, might cause problems in cross-cultural medical encounters. Adequate awareness of such variations may enhance understanding between Japanese doctors and patients from other cultures.
