Generic characteristics of patients’ e-consultations with general practitioners
Keywords: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.
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. https://doi.org/10.1542/peds.2004-1297
Antoun, Jumana (2016) Electronic mail communication between physicians and patients: A review of challenges and opportunities. Family Practice 33 (2): 121–126. https://doi.org/10.1093/fampra/cmv101
Askehave, Inger and Karen K. Zethsen (2008) Mandatory genres: The case of European Public Assessment Report (EPAR) summaries. Text & Talk 28 (2): 167–191. https://doi.org/10.1515/TEXT.2008.008
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. https://doi.org/10.2196/18218
Barron, Anne (2006) Understanding spam: A macro-textual analysis. Journal of Pragmatics 38 (6): 880–904. https://doi.org/10.1016/j.pragma.2005.04.009
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. https://doi.org/10.1016/j.esp.2007.07.005
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. https://doi.org/10.1136/bmjopen-2017-016901
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. https://doi.org/10.1179/2047480615Z.000000000325
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. https://doi.org/10.1558/cam.18399
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. https://doi.org/10.2307/2787034
Graves, Lucas (2007) The affordances of Blogging: A case study in culture and technological effects. Journal of Communication Inquiry 31 (4): 331–346. https://doi.org/10.1177/0196859907305446
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. https://doi.org/10.1136/bmjopen-2020-039442
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. https://doi.org/10.1016/B0-12-387670-2/00078-9
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: http://ojs.statsbiblioteket.dk/index.php/mediekultur/article/view/5733/5050
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. https://doi.org/10.1177/108056990606900215
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: https://doi.org/10.7146/tjcp.v8i1.123038
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. https://doi.org/10.1177/14687941211061058
Louhiala-Salminen, Leena (1996) The business communication classroom vs reality: What should we teach today? English for Specific
Purposes 15 (1): 37–51. https://doi.org/10.1016/0889-4906(95)00024-0
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. https://doi.org/10.4304/tpls.3.12.2250-2261
Miller, Carolyn R. (1984) Genre as social action. Quarterly Journal of Speech 70 (2): 151–167. https://doi.org/10.1080/00335638409383686
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. https://doi.org/10.1080/10810730.2015.1033118
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. https://doi.org/10.2196/13042.
Møller, Jane E., Antoinette Fage-Butler and Matilde Nisbeth Brøgger (2021) Complexity and simplicity in doctor–patient email consultations. Conjunctions 8 (1). Online: https://doi.org/10.7146/tjcp.v8i1.123039
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. https://doi.org/10.2307/2393771
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: https://www.laeger.dk/media/s5himhao/aktivitet_og_oekonomi_2021pdf_-_august_2022.pdf
Praktiserende Lægers Organisation [Danish Organization of General Practitioners] (2022b) Honorartabel [Remuneration table]. Online: https://www.laeger.dk/media/owclyvfi/honorartabel_2022_oktober.pdf
Praktiserende Lægers Organisation [Danish Organization of General Practitioners] (2022c) Overenskomst om almen praksis 2022 [Agreement in General Practice 2022]. Online: https://www.laeger.dk/media/bmhpndle/plo_overenskomst_2022_web-1.pdf
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. https://doi.org/10.1109/IPCC.1995.554879
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. https://doi.org/10.1515/come.2004.1.2.159
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. https://doi.org/10.2190/TW.39.1.c
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. https://doi.org/10.1207/S15327027HC1403_2
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. https://doi.org/10.1016/j.pec.2009.09.038
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.
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