The Dynamic Consultation

This book introduces a unique model of medical discourse that identifies the forms of talk – voices – that doctors and patients use during the consultation, and studies the dynamic interaction as it unfolds particularly in follow-up visits. Natural recordings, semi-structured interviews, questionnaires and ethnographic observations provide the data for the research, which was carried out in an Outpatient Clinic in Santiago, Chile. Using an interactional sociolinguistic approach, analysis of the data identifies doctor–patient communication as a micro-performance of broader socio-cultural realities, in which social status, power, knowledge and personal beliefs and values all find expression in the consultative setting. Importantly, while both doctor and patient voices are shown to contribute to an essentially asymmetrical exchange, the study also identifies the holistic and empathic Fellow Human voice, which places doctors and patients on a more equal footing. In connection with this voice, the Spanish concept of simpatía is also discussed.While the model in this study was developed within a specific socio-cultural framework, it is hoped that it will be adapted and modified more widely and contribute to a better understanding between doctors and their patients.

This book introduces a unique model of medical discourse that identifies the forms of talk – voices – that doctors and patients use during the consultation, and studies the dynamic interaction as it unfolds particularly in follow-up visits. Natural recordings, semi-structured interviews, questionnaires and ethnographic observations provide the data for the research, which was carried out in an Outpatient Clinic in Santiago, Chile. Using an interactional sociolinguistic approach, analysis of the data identifies doctor–patient communication as a micro-performance of broader socio-cultural realities, in which social status, power, knowledge and personal beliefs and values all find expression in the consultative setting. Importantly, while both doctor and patient voices are shown to contribute to an essentially asymmetrical exchange, the study also identifies the holistic and empathic Fellow Human voice, which places doctors and patients on a more equal footing. In connection with this voice, the Spanish concept of simpatía is also discussed.While the model in this study was developed within a specific socio-cultural framework, it is hoped that it will be adapted and modified more widely and contribute to a better understanding between doctors and their patients.

Unique resource detailing the day-to-day activity of doctors who work on “the coal face” of psychiatry in an acute setting Dynamic Consultations With Psychiatrists is the outcome of a collaboration between the psychiatrists of a certain hospital and the author, which has continued successfully for more than ten years, containing a number of patient consultations and cases where psychiatry was used successfully to solve a patient’s problem. The presentation of each case, and particularly of the consultation, is meant to demonstrate the process by which insights were gained. Each consultation is written in plain English with the deliberate avoidance of terminology and especially psychoanalytic jargon. Naturally, all identified features of the patients have been deleted or changed so that the patients’ privacy is not compromised. The format is near to a transcript so that the work demonstrates how the understanding evolves and emerges from the process. The structure of the book is not according to a diagnosis but according to “presenting problem” (in other words, the most prominent feature), allowing for easy and efficient accessibility. Sample concepts and learning resources covered and included in Dynamic Consultations With Psychiatrists are as follows: How a doctor is faced with a patient who is suffering in their own particular way and how the clinician gets to develop a deeper understanding of their predicament Difficulties the “coal face” doctors encounter and the challenges they will face in their personal emotional wellbeing Relationships with the other professionals both within their hospital and other agencies Curtailed histories so that there is a seamless exposition of how the conclusions of the consultation have been reached Psychiatrists, psychotherapists, and students/instructors in related programs of study can use Dynamic Consultations With Psychiatrists to gain valuable insight into the thought process of practicing psychiatrists in relation to a myriad of patient problems, allowing them to learn vicariously and become better at dealing with their own patients’ problems.

The authors examine the role of the consultant in assisting leaders to understand change from a dynamic systems perspective and to manage that change strategically. The case examples they present emphasize the need for consultants to connect the internal psychological landscapes of executives. managers, and employees with their external manifestations during times of organizational transformation, while remaining attuned to the impact of these issues on the consultant's own lives and work.

This book illustrates clinical, psychoanalytic approaches to understanding people in depth, even when breadth of understanding is severely constricted by the brevity of a consultation. It considers the changing times in which psychoanalytic psychotherapists carry on consulting.

English Language and the Medical Profession: Instructing and Assessing the Communication Skills of International Physicians is designed for a new context for English language teaching: the emerging, worldwide interest in English for medicine. The book offers a program for an English language curriculum that is specifically designed for the important and growing group of international medical professionals, with a focus on both instruction and assessment. International physicians in the United States now total more than 25 per cent of the physician workforce. Even subsequent to their passage of the clinical skills exam required for licensing and practice as physicians in U.S. hospitals, international physicians face communication challenges as first-year residents and may be referred to specialists for language and cultural issues. Advanced residents may face additional issues when they begin work as independent practitioners. This volume goes beyond existing texts in collecting the expertise of English language teaching and testing experts, medical residency supervisors, medical licensing, and exchange agencies in examining issues related to international physicians' performance as graduate students and doctors in hospitals and other settings. The contributors include specialists at the Educational Commission for Foreign Medical Graduates and doctors who supervise international medical residents as well as recognized ESP practitioners.

This book challenges two tacit presumptions in the field of intercultural communication research. Firstly, misunderstandings can frequently be found in intercultural communication, although, one could not claim that intercultural communication is constituted by misunderstandings alone. This volume shows how new perspectives on linguistic analyses of intercultural communication go beyond the analysis of misunderstanding. Secondly, intercultural communication is not solely constituted by the fact that individuals from different cultural groups interact. Each contribution of this volume analyses to what extent instances of discourse are institutionally and/or interculturally determined. These linguistic reflections involve different theoretical frameworks, e.g. functional grammar, systemic functional linguistics, functional pragmatics, rhetorical conversation analysis, ethno-methodological conversation analysis, linguistic an­thro­­pology and a critical discourse approach. As the contributions focus on the discourse of genetic counseling, gate-keeping discourse, international team co-operation, international business communication, workplace discourse, internet communication, and lamentation discourse, the book exemplifies that the analysis of intercultural communication is organized in response to social needs and, therefore, may contribute to the social justification of linguistics.