Generic characteristics of patients’ e-consultations with general practitioners


  • Ditte Laursen Royal Danish Library
  • Matilde Nisbeth Brøgger Aarhus University
  • Antoinette Fage-Butler Aarhus University
  • Jane Ege Møller Aarhus University
  • Anette Grønning University of Southern Denmark



e-consultation, genre, digital communication, Denmark, e-mail general practice


Electronic communication between patients and general practitioners (GPs), known as e-consultations, was introduced in Denmark as a cost-effective and convenient means for patients to access their GP and receive test results as well as answers to quick questions. Research on e-consultations internationally has found that patients are generally very positive, while doctors are more hesitant. Most studies of e-consultations have involved survey or interview methodologies, while studies of their content, form or language are limited. In this study, we address this gap by proposing that genre may be a productive concept for comprehending textual aspects of e-consultations. We explore the following two questions: (1) what are the generic characteristics of the e-consultation?; and (2) do e-consultations belong to the email genre? Based on an analysis of two Danish corpora of patients’ first turns in e-consultations with their GPs, we identify an underlying move structure: subject, opening, update, problem presentation, request, argumentation, closing. We argue that the e-consultation is an example of an email genre with identifiable conventions, which are both specific to the communicative function of e-consultations and aligned with generic features of emails.

Author Biographies

Ditte Laursen, Royal Danish Library

Ditte Laursen received her PhD in Digital Communication from University of Southern Denmark and she is currently Head of Department at the Royal Danish Library. Her research interests are social interaction across formal, semi-formal and informal digital media sites, as well as the methodological challenges involved in capturing and archiving social interaction on and related to digital media.

Matilde Nisbeth Brøgger, Aarhus University

Matilde Nisbeth Brøgger received her PhD in Business Communication/Linguistics from Aarhus University, Denmark and Macquarie University, Australia and is currently an Associate Professor of International Business Communication and Health Communication at Aarhus University, Denmark. Her research interests include various aspects of (mediated) health communication such as expert–lay communication, patient–patient communication, email communication and medical translation.

Antoinette Fage-Butler, Aarhus University

Antoinette Fage-Butler received her PhD in Knowledge Communication from Aarhus University, Denmark, where she is currently an Associate Professor. Her research interests include cultural aspects of health, risk communication and communicating trust. She is currently writing a monograph on risk and responsibilisation in relation to global crises.

Jane Ege Møller, Aarhus University

Jane Ege Møller received her PhD in Philosophy and Health from Aarhus University, Denmark, where she is currently an Associate Professor of Health and Humanities. Her research interests include interpersonal health communication (doctor–patient, email), inter-collegial communication, narrative medicine and postgraduate medical education.

Anette Grønning, University of Southern Denmark

Anette Grønning received her PhD in Digital Communication from Copenhagen Business School, Denmark and she is currently an Associate Professor of Media Studies at University of Southern Denmark,
Denmark. Her research interests include various aspects of digital communication and social media, such as mediated discourse, participation and social presence, primarily in workplace settings.


Alafnan, Mohammad A. (2015) Language use in computer-mediated communication: An investigation into the genre of workplace emails. International Journal of Education and Literacy Studies 3 (1): 1–11.

Amirian, Zahra and Mohammad H. Tahririan (2003) Analysis of e-mail genre: A new perspective to EAP writing. Iranian Journal of Applied Linguistics 6 (1): 21–39.

Anand, Shikha G., Mitchell J. Feldman, David S. Geller, Alice Bisbee and Howard Bauchner (2005) A content analysis of e-mail communication between primary care providers and parents. Pediatrics 115 (5): 1283–1288.

Antoun, Jumana (2016) Electronic mail communication between physicians and patients: A review of challenges and opportunities. Family Practice 33 (2): 121–126.

Askehave, Inger and Karen K. Zethsen (2008) Mandatory genres: The case of European Public Assessment Report (EPAR) summaries. Text & Talk 28 (2): 167–191.

Atherton, Helen, Anne-Marie Boylan, Abi Eccles Joanna Fleming, Clare R. Goyder and Rebecca L. Morris (2020) Email consultations

between patients and doctors in primary care: Content analysis. Journal of Medical Internet Research 22 (11): Article e18218.

Barron, Anne (2006) Understanding spam: A macro-textual analysis. Journal of Pragmatics 38 (6): 880–904.

Beckman, Howard B. and Richard M. Frankel (1984) The effect of physician behavior on the collection of data. Annals of Internal Medicine 101 (5): 692–696.

Berkenkotter, Carol A. and Thomas N. Huckin (1995) Genre Knowledge in Disciplinary Communication – Cognition/Culture/Power. Hillsdale, NJ: Lawrence Erlbaum Associates.

Bhatia, Vijay K. (1993) Analysing Genre: Language Use in Professional Settings. London: Longman.

Bhatia, Vijay K. (1996) Methodological issues in genre analysis. Hermes, Journal of Linguistics 16: 39–59.

Bhatia, Vijay K. (2002) Applied genre analysis: Analytical advances and pedagogical procedures. In Ann M. Johns (ed.) Genre in the Classroom: Multiple Perspectives, 279–283. Mahwah, NJ: Erlbaum.

Bhatia, Vijay K. (2004) Worlds of Written Discourse: A Genre-Based View. London: Bloomsbury.

Bhatia, Vijay K. (2008) Genre analysis, ESP and professional practice. English for Specific Purposes 27 (2): 161–174.

Bucher, Taina and Anne Helmond (2018) The affordances of social media platforms. In Jean Burgess, Alice E. Marwick and Thomas Poell (eds) The Sage Handbook of Social Media, 233–253. London: Sage.

Edwards, Hannah B., Elsa Marques, William Hollingworth, Jeremy Horwood, Michelle Farr, Elly Bernard Chris Salisbury and Kate Northstone (2017) Use of a primary care online consultation system, by whom, when and why: Evaluation of a pilot observational study in 36 general practices in South West England. British Medical Journal Open 7 (11): Article e016901.

Fage-Butler, Antoinette (2015) Package leaflets for medication in the EU: The possibility of integrating patients’ perspectives in a regulated genre? Medical Writing 24 (4): 210–214.

Fage-Butler, Antoinette and Matilde Nisbeth Jensen (2015) The relevance of existing health communication models in the email age: An integrative literature review. Communication & Medicine 12 (2–3): 117–128.

Frow, John (2006) Genre: The New Critical Idiom. London: Routledge.

Gill, Virginia T. (1998) Doing attributions in medical interaction: Patients’ explanations for illness and doctors’ responses. Social Psychology Quarterly 61 (4): 342–360.

Graves, Lucas (2007) The affordances of Blogging: A case study in culture and technological effects. Journal of Communication Inquiry 31 (4): 331–346.

Grønning, Anette (2006) Personen bag: Tilstedevær i e-mail som interaktionsform mellem kunde og medarbejder i dansk forsikringskontekst. [The person behind: Social presence in email as interaction form between customer and employee in a Danish insurance context]. Unpublished doctoral dissertation, Copenhagen Business School, Frederiksberg, Denmark.

Grønning, Anette, Elisabeth Assing Hvidt, Matilde Nisbeth Brøgger and Antoinette Fage-Butler (2020) How do patients and general practitioners in Denmark perceive the communicative advantages and disadvantages of access via email consultations? A media-theoretical qualitative study. British Medical Journal Open 10 (10): Article e039442.

Harrison, Teresa M. (2003) Electronic mail. In Donald H. Johnston (ed.-in-chief) Encyclopedia of International Media and Communications, Volume 2, 505–513. San Diego, CA: Academic Press.

Helder, Bodil (2011) Textual Analysis: An Approach to Analysing Professional Texts. Frederiksberg, Denmark: Samfundslitteratur.

Heritage, John and Jeffrey Robinson (2006) Accounting for the visit: Giving reasons for seeking medical care. In John Heritage and Douglas W. Maynard (eds) Communication in Medical Care: Interaction between Primary Care Physicians and Patients, 48–85. Cambridge: Cambridge University Press.

Hutchby, Ian (2001) Conversation and Technology. From the Telephone to the Internet. Cambridge: Polity Press.

Jerslev, Anne, Mette Mortensen and Line N. Petersen (2011) Challenging genre – Genre challenges. New media, new boundaries, new formations. Introduction. MedieKultur: Journal Of Media And Communication Research 27 (51). Online:

Kankaanranta, Anne (2005) ‘Hej Seppo, could you pls comment on this’ – Internal email communication in lingua Franca English in a multi-national company. Business Communication Quarterly 69 (2): 215–225.

Klausen, Maja and Anette Grønning (2021) My throat ‘tickles’: Bodies in affective discourse in patient–doctor email consultations. Conjunctions: Transdisciplinary Journal of Cultural Participation 8 (1). Online:

Kurtz, Suzanne, Jonathan D. Silverman and Juliet Draper (1998) The Calgary–Cambridge Referenced Observation Guides: An aid to defining the curriculum and organizing the teaching in communication training programmes. Medical Education 30 (2): 83–89.

Laursen, Ditte, Line Maria Simonsen and Anette Grønning (2022) Methodological challenges in researching email consultations as a form of communication in patient-provider interactions. Qualitative Research. Online first.

Louhiala-Salminen, Leena (1996) The business communication classroom vs reality: What should we teach today? English for Specific

Purposes 15 (1): 37–51.

Martin, James R. (1985) Process and text: Two aspects of human semiosis. In James D. Benson and William S. Greaves (eds) Systemic Perspectives on Discourse, Volume 1, 248–274. Norwood, NJ: Ablex.

Mehrpour, Saeed and Mohaddeseh Mehrzad (2013) A comparative genre analysis of English business e-mails written by Iranians and native English speakers. Theory and Practice in Language Studies 3 (12): 2250–2261.

Miller, Carolyn R. (1984) Genre as social action. Quarterly Journal of Speech 70 (2): 151–167.

Mirsky, Jacob B., Lina Tieu, Courtney Lyles and Urmimala Sarkar (2016) A mixed-methods study of patient-provider e-mail content in a safety-net setting. Journal of Health Communication 21 (1): 85–91.

Mold, Freda, Jane Hendy, Yi-Ling Lai and Simon de Lusignan (2019) Electronic consultation in primary care between providers and patients: Systematic review. Journal of Medical Internet Research Medical Informatics 7 (4): 4–17.

Møller, Jane E., Antoinette Fage-Butler and Matilde Nisbeth Brøgger (2021) Complexity and simplicity in doctor–patient email consultations. Conjunctions 8 (1). Online:

Nisbeth Jensen, Matilde (2013) Translators of Patient Information Leaflets: Translation Experts or Expert Translators? A Mixed Methods Study of Lay-friendliness. Unpublished doctoral dissertation, Aarhus University, Aarhus, Denmark.

Orlikowski, Wanda J. and JoAnne Yates (1994) Genre repertoire: Examining the structuring of communicative practices in organizations? Administrative Science Quarterly 39 (4): 541–574.

Praktiserende Lægers Organisation [Danish Organization of General Practitioners] (2022a) Aktivitet og økonomi i almen praksis i dagtid og vagttid 2012 til 2021 [Activity and Economy in General Practice 2012–2021]. Online:

Praktiserende Lægers Organisation [Danish Organization of General Practitioners] (2022b) Honorartabel [Remuneration table]. Online:

Praktiserende Lægers Organisation [Danish Organization of General Practitioners] (2022c) Overenskomst om almen praksis 2022 [Agreement in General Practice 2022]. Online:

Rice, Rodney P. (1995) The rhetoric of e-mail: An analysis of style. Institute of Electrical and Electronics Engineers International Professional Communication Conference (IPCC) 95 Proceedings, September 27 to September 29, 1995, Savannah, Georgia: Smooth Sailing to the Future, 110–115. Piscataway, NJ: Institute of Electrical and Electronics Engineers.

Roberts, Celia, Srikant Sarangi and Becky Moss (2004) Presentation of self and symptoms in primary care consultations involving patients from non-English speaking backgrounds. Communication & Medicine 1 (2):159–169.

Ross, Derek G. (2009) ARS dictaminis perverted: The personal solicitation e-mail as a genre. Journal of Technical Writing and Communication 39 (1): 25–41.

Sacks, Harvey (1992) Lectures on Conversation. 2 vols. Oxford: Blackwell.

Schegloff, Emanuel A. and Harvey Sacks (1973) Opening up closings. Semiotica 8 (4): 289–327.

Silverman, David (2016) Qualitative Research. London: Sage.

Spooner, Michael and Kathleen Yancey (1996) Postings on a genre of email. College Composition and Communication 47 (2): 252–278.

Stivers, Tanya (2002) Presenting the problem in pediatric encounters: ‘Symptoms only’ versus ‘candidate diagnosis’ presentations. Health Communication 14 (3): 299–338.

Stommel, Wyke (2012) Salutations, closings and pronouns: Some aspects of recipient design in online counselling. Communication & Medicine 9 (2): 145–158.

Stommel, Wyke and Fleur van der Houwen (2015) Counseling and new media technologies: A comparison of problem presentations in e-mail and in chat. Communication & Medicine 12 (2–3): 243–256.

Swales, John M. (1990) Genre Analysis: English in Academic and Research Settings. Cambridge: Cambridge University Press.

Swales, John M. (1996). Occluded genres in the academy: The case of the submission letter. In Eija Ventola and Anna Mauranen (eds) Academic Writing: Intercultural and Textural Issues, 45–58. Amsterdam: John Benjamins.

Upton, Thomas A. (2002) Understanding direct mail letters as a genre. International Journal of Corpus Linguistics 7 (1): 65–85.

Ye, Jiali, George Rust, Yvonne Fry-Johnson and Harry Strothers (2010) E-mail in patient–provider communication: A systematic review. Patient Education and Counseling 80 (2): 266–273.

Zsubrinszky, Zsuzsanna (2009) A Genre-Based Description of Business Emails: A Study of British and Hungarian Business People’s L1 and L2 Business Emails. Budapest: Eötvös Loránd University.



How to Cite

Laursen, D., Nisbeth Brøgger, M., Fage-Butler, A., Ege Møller, J., & Grønning, A. (2023). Generic characteristics of patients’ e-consultations with general practitioners. Communication and Medicine, 18(2), 168–184.