An Interpersonal Pragmatic Study Of Identity Construction In Online Doctor-patient Interaction

Doctor-patient interaction is a crucial ingredient in effective health care(Perloff et al.,2006).Much of the success of medical consultations depends on the quality of interactions between doctors and patients.With the advent of the internet plus era,the location and mode of medical consultations have witnessed an extraordinary change.Due to its convenience and effectiveness,online medical consultations enjoy wide popularity among patients.Moreover,such effectiveness is principally contingent upon the adequate and harmonious interactions between doctors and patients.Hence,this thesis combines online doctor-patient interaction with identity construction,which concentrates on two aspects: first,the linguistic realizations and properties of identity construction;second,the interpersonal functions achieved in the process of identity construction and implications for the harmonious relationship between doctors and patients.Identity is dynamically and intersubjectively constructed in the unfolding of interaction,changing from one situation to another.Drawing upon the observation of100 pieces of naturally-occurring online medical consultations,it is discovered that identity construction is a multilevel process which manifests three properties,diversity,flexibility and intersubjectivity.At the macro level,two significant kinds of identity can be found in online doctor-patient interaction,that is,default identity and deviational identities.The default identity stands for the traditional expert-novice identity in the medical institution,while the deviational identities as the mitigation of institutional authority include three identity pairs: educator-student identities,friend-friend identities,and server-customer identities.And then those pragmatic identities are constructed by doctors and patients with the use of two kinds of linguistic strategies at the intermediate level,encompassing pragmatic strategies and semantic strategies.Based on that,specific discourse choices are the realizations of identities at the micro level.By taking on different identities,doctors and patients intend to fulfill specific transactional purposes,including seeking information,offering medical advice,seeking maximum help,imparting medical knowledge and instructions,seeking further explanations,lowering anxiety and stress,obtaining positive feedback,and marketing medicine.All these transactional purposes aim at the ultimate goal of ongoing medical consultation,which is the success of curing.Identity construction as an interpersonal resource can inextricably exert an impact on the interpersonal relationship between interlocutors.Their relations can be observed through three aspects of interpersonal pragmatics,namely,interpersonal relations,interpersonal attitudes and emotions,and interpersonal evaluations.Those three aspects interact with each other and serve as a wheel through which the interpersonal functions of identity construction can be probed.In the medical setting,different identities enacted by doctors and patients influence their interpersonal relations in terms of power relations,which may help to achieve the function of institutional authority management,including authority alignment and mitigation.Besides,identity construction signifies the position of the doctors and patients and reflects their social relations,thus realizing empathy and de-empathy.Those different social relations elicit twofold interpersonal evaluations as politeness and impoliteness.By analyzing the interpersonal functions of identity construction in online doctor-patient interaction,it is eventually showed that mutual trust and respect are the powerful guarantee to promote the positive rapport between doctors and patients.The thesis provides an empirical study of the contextualized pragmatic identity construction in online doctor-patient interaction within a constructed analytical framework,offering constructive insights for doctors and patients to choose appropriate identities so as to build a harmonious doctor-patient relationship.Nonetheless,it is noteworthy that the strategies exploited for identity construction vary and should not be restricted to the communication at the linguistic level.Thus,empirical studies on the functions of non-verbal means of identity construction merit further investigation,so as to understand more comprehensively the identity choice of doctors and patients,and eventually promote the harmony between them.