Could patients’ coughing have communicative significance?


  • Julia V. Bailey Research Department of Primary Care and Population Health, University College London



physician–patient relations, sociolinguistic analysis, discourse analysis, coughing, non-verbal communication, upper respiratory tract infection


Medical discourse positions patients with coughs and colds negatively, so consulting health services with ‘minor’ respiratory illness is therefore more accountable than for other medical problems. Patients face dilemmas since they must persuade doctors of the doctorability of their illness without being seen as hypochondriacal, and they risk losing face if doctors decide that there is nothing much wrong. It is known that the placement of non-lexical features of talk such as laughing or crying can have interactional meaning. Using a data set of videorecorded doctor–patient cough and cold consultations, this study explores whether patients’ coughing could have communicative significance. The study is a qualitative analysis of 33 consultations drawing on a constructionist, sociolinguistic analytic approach. Coughing is co-ordinated with talk rather than occurring randomly. Coughing helps patients to demonstrate the doctorability of their symptoms and to legitimize their claims for medical attention. Coughing is also associated with resistance to ‘no problem’ diagnoses, resulting in changes in the trajectory of talk (for example, soliciting more explanation from doctors and/or re-negotiation of doctors’ investigation or treatment plans). Coughing is undoubtedly a manifestation of respiratory illness, but also has communicative significance in consultations for coughs and colds.

Author Biography

Julia V. Bailey, Research Department of Primary Care and Population Health, University College London

Julia Bailey is a clinical lecturer (Walport Lecturer) in the e-health unit at University College London. She is also a medical doctor. This work derives from her PhD thesis entitled ‘Doctor–Patient Communication in Consultations for Upper Respiratory Tract Infections: a Discourse Analysis’ (2007), supervised by Professors Celia Roberts, Roger Jones and Jane Barlow. Address for correspondence: Research Department of Primary Care and Population Health, University College London, Level 2, Holborn Union Building, Highgate Hill, London N19 5LW.



How to Cite

Bailey, J. V. (2009). Could patients’ coughing have communicative significance?. Communication and Medicine, 5(2), 105–115.