Understanding the Co-construction of Medical Consultations in Traditional Chinese Medicine: A Discourse Structural Analysis

Findings from previous research on Western medical consultations indicate that the doctor–patient relationship involved in these consultations is mostly asymmetrical. This asymmetry of relationship is clearly revealed in the analysis of participants’ conversational dominance in doctor–patient interactions. This chapter argues that the doctor–patient relationship in Traditional Chinese Medicine (TCM) consultations may be different with that in Western medical consultations. With audio recordings and transcriptions of 28 conversations between TCM practitioners and patients, this chapter examines the sequential structure of TCM consultations and speech functions of doctors and patients in the TCM context. The findings show that small talk contributes to a more symmetrical doctor–patient relationship because both the TCM practitioners and patient are engaged in it. The prevalence of explanations indicates the feature of patient-centered approach in TCM consultations. Moreover, the statistical test in speech function frequencies of doctors and patients further supports the claim that the doctor–patient relationship in TCM consultations may be more symmetrical as insignificant differences of the frequencies are observed. Based on the analyses, this chapter further suggests that TCM consultations are co-constructed by both TCM practitioners and patients.