Third party insurance?

Interactional role alignment in family member mediated primary care consultations

Authors

  • Celia Roberts King's College, London
  • Srikant Sarangi Aalborg University

DOI:

https://doi.org/10.1558/cam.38675

Keywords:

lay interpreters, mediation, narrative performance, participation frameworks, primary care consultation, role relations, third party

Abstract

This paper deals with general practice consultations where there is a third party present, as a companion, to support the patient and act as a mediator between doctor and patient. Our study contrasts with most, but by no means all, of the studies on interpreting, which (1) focus on a transmission of information model in professional interpreting, (2) do not address monolingual mediated consultations where the third person is a carer and/or (3) do not address issues of trust and feelings which can characterise consultations mediated by family members. The data for this paper is drawn from a Londonbased project: Patients with Limited English and Doctors in General Practice: Educational Issues (PLEDGE). Using Goffman’s participant framework and aspects of narrative performance, we propose a cline of mediation, which can be mapped onto the structure of the clinical consultation – as evidenced through two case studies. The analysis indicates that consultations with companions that act as lay interpreters have more in common with monolingual triadic consultations than with professionally interpreted consultations. The shifts in role-relationships and alignments between the three participants subvert their official position to produce a remarkable intimacy and collaboration, while often subduing but sometimes amplifying the patient’s voice. There are implications of our findings both for family carers as mediators and for primary care health providers.

Author Biographies

Celia Roberts, King's College, London

Celia Roberts is Professor Emerita in Sociolinguistics and Applied Linguistics, King’s College London. Her publications in language and inequality in institutional contexts include Language and Discrimination (with Davies and Jupp; Longman, 1992), Achieving Understanding (with Bremer et al.; Longman, 1996), Talk, Work and Institutional Order (with Sarangi; De Gruyter, 1996) Language Learners as Ethnographers (with Byram et al.; Multilingual Matters, 2001) and Performance Features in Clinical Skills Assessment (with Atkins and Hawthorne; King’s College London, 2014). Her forthcoming book Linguistic Penalties examines the inequalities migrants face in job interviewing.

Srikant Sarangi, Aalborg University

Srikant Sarangi is Professor in Humanities and Medicine and Director of the Danish Institute of Humanities and Medicine (DIHM) at Aalborg University, Denmark. Between 1993 and 2013 he was Professor in Language and Communication and Director of the Health Communication Research Centre at Cardiff University (UK), where he continues as Emeritus Professor. Beginning 2017, he is also Adjunct Professor at Norwegian University of Science and Technology (NTNU), Visiting Professor at the University of Jyväskylä, Finland and Visiting Professor at the College of Medicine, Qatar University. In 2012, he was awarded the title of ‘Fellow’ by the Academy of Social Sciences, UK. His research interests are in institutional/professional discourse studies (e.g., healthcare, social work, bureaucracy, education) and applied linguistics. He is editor of Text & Talk, Communication & Medicine and Journal of Applied Linguistics and Professional Practice.

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Published

2020-03-14

How to Cite

Roberts, C., & Sarangi, S. (2020). Third party insurance? Interactional role alignment in family member mediated primary care consultations. Communication and Medicine, 15(2), 191–205. https://doi.org/10.1558/cam.38675