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PubMed · 12024537

The medium and the message.

M Marinker
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Abstract

Communication between doctor and patient is examined in relation to ways of describing the institution of medicine, the rules of engagement between doctor and patient, and the language they employ. Medicine and its institutions are presented in metaphorical terms; a theatrical taxonomy of consultations between patient and doctor is suggested; and patient-doctor communication is considered in the light of the pervasiveness of mistranslation. Because it is possible to invent a wide range of alternative metaphors for medical institutions, to envisage many different sorts of dramatic possibilities in the patient-doctor encounter, and to develop a respect for the particularity of all language, optimism is expressed about the future of research, teaching and practice in doctor-patient communication.

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CommunicationHumansPhysician-Patient RelationsSchools, MedicalAddress

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M Marinker. 2000. The medium and the message.. https://doi.org/10.1016/s0738-3991(00)00138-5

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Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

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