A CRITICAL DISCOURSE ANALYSIS OF DOCTOR-PATIENT CONVERSATIONS IN SELECTED RURAL HOSPITALS IN KADUNA STATE
The use of language in human communication is predicated on social relationships; hence when people converse, they are always aware of the social relationship which determines who controls and directs the conversation. This study focuses on doctor-patient conversations in rural areas. It investigates how language is employed as a tool of social dominance in doctor-patient conversations in selected rural hospitals in Kaduna State, Nigeria. The aim is to examine and understand the nature of doctor-patient conversations in the selected rural hospitals in order to reveal the underlying power struggle. The study employs the theoretical paradigm of Fairclough‘s (1989) Discourse as Social Practice which is used to analyse the data. A total of twenty (20) conversations between doctors and patients are recorded, translated and transcribed. Twenty (20) patients are also interviewed in order to determine the level of patient satisfaction and Five (5) different doctor-patient conversations are selected for analysis at the levels of description, interpretation and explanation as proposed by Fairclough (1989). The study reveals that doctor-patient conversation in the selected rural areas is shaped by both the institution of medicine and the customs and traditions of the people in such areas where it occurs. It also reveals that the presence of a traditional ideology of health in these rural areas has an impact on the power dynamics and results in a power struggle. Another finding is that the communication style of doctors in rural areas is disease-centred, as opposed to patient-centred which as proven by William, Weinman & Dale (1998) leads to higher patient satisfaction. Finally, this study has successfully confirmed the fact that conversations between doctors and patients in rural areas are laced with unequal power relationship which is seen in their use of language.