Reconfiguring self/identity/status/role
The case of professional role performance in healthcare encounters
DOI:
https://doi.org/10.1558/japl.v7i1.75Keywords:
professional role performance, role-set, therapeutic and pedagogic roles, online commentaries, off-line commentaries, primary care consultationAbstract
Concepts such as self, identity, status and role are central to discourse analytical endeavours. However, these concepts are used interchangeably, and sometimes in a conflated manner (e.g., self-identity, role-identity), by scholars within and across different analytical domains with overlapping ontological and epistemological trajectories. Beginning with a broader theoretical discussion of self, status and identity from sociological and social psychological traditions, in this paper I focus on role and role performance in professional settings. Using Goffman’s work as a bridge I then offer an interactional perspective on role performance which is extended to the doctorpatient relationship in healthcare encounters. The illustrative data examples are taken from the primary care setting, drawing attention to the doctor’s competing roles, i.e., therapeutic and pedagogic, contained within the professional role-set in an ethos which is predominantly steered towards patient-centred healthcare delivery. My main argument is that an examination of professional role-performance at the interactional level is capable of offering interesting theoretical and empirical insights.
References
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Balint, M. (1957) The Doctor, His Patient and the Illness. Edinburgh: Churchill Livingstone.
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Elliott, P. (1972) The Sociology of the Professions. London: Macmillan.
Ferrara, K. W. (1994) Therapeutic Ways with Words. New York: Oxford University Press.
Frank, A. W. (1995) The Wounded Storyteller: Body, Illness and Ethics. Chicago, IL: University of Chicago Press.
Freidson, E. (1975) [1970] Profession of Medicine: A Study of the Sociology of Applied Knowledge. New York: Dodd, Mead & Company.
Foucault, M. (1972) The Archaeology of Knowledge (trans. A. M. Sheridan Smith). New York: Pantheon Books.
Giddens, A. (1991) Modernity and Self-Identity: Self and Society in the Late Modern Age. Cambridge: Polity Press.
Goffman, E. (1959) The Presentation of Self in Everyday Life. New York: Doubleday.
Goffman, E. (1961) Encounters: Two Studies in the Sociology of Interaction. Indianapolis, IN: Bobbs-Merrill.
Goffman, E. (1974) Frame Analysis. New York: Harper & Row.
Goffman, E. (1981) Forms of Talk. Oxford: Blackwell.
Halkowski, T. (1990) ‘Role’ as an interactional device. Social Problems 37 (4): 564–577. doi:10.1525/sp.1990.37.4.03a00100
Hall, C., Sarangi, S. and Slembrouck, S. (1999) The legitimation of the client and the profession: Identities and roles in social work discourse. In S. Sarangi and C. Roberts (eds) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings, 293–322. Berlin: Mouton de Gruyter.
Hall, S. and Du Gay, P. (eds) (1996) Questions of Cultural Identity. London: Sage.
Heritage, J. and Stivers, T. (1999) Online commentary in acute medical visits: A method of shaping patient expectations. Social Science & Medicine 49 (11): 1501–1517. doi:10.1016/ S0277-9536(99)00219-1
Hilbert, R. (1981) Toward an improved understanding of ‘role’. Theory and Society 10 (2): 207–226. doi:10.1007/BF00139892
Katz, E. and Danet, B. (eds) (1973) Bureaucracy and the Public: A Reader in Official-Client Relations. New York: Basic Books.
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Sarangi, S. (2007) Other-orientation in patient-centred healthcare communication: Unveiled ideology or discoursal ecology? In G. Garzone and S. Sarangi (eds) Discourse, Ideology and Ethics in Specialised Communication, 39–71. Berne: Peter Lang.
Sarangi, S. (in press) Owning responsible actions/selves: Parental accounts in the context of childhood genetic testing. In J.-O. Östman and A. Solin (eds) Discourse and Responsibility in Professional Settings. London: Equinox.
Sarangi, S. and Clarke, A. (2002) Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction 35 (2): 139– 171. doi:10.1207/S15327973RLSI3502_2
Sarangi, S. and Roberts, C. (eds) (1999) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings. Berlin: Mouton de Gruyter.
Sarangi, S. and Slembrouck, S. (1996) Language, Bureaucracy and Social Control. London: Longman.
Strong, P. M. and Davis, A. G. (1978) Who’s who in paediatric encounters: Morality, expertise and the generation of identity and action in medical settings. In A. G. Davis (ed.) Relationships Between Doctors and Patients, 48–75. Farnborough: Saxton House.
Thomas, J. A. (1986) The Dynamics of Discourse: A Pragmatic Analysis of Confrontational Interaction. Unpublished Doctoral Thesis. Lancaster University.
Turner, R. H. (1962) Role-taking: Process versus conformity. In A. Rose (ed.) Human Behaviour and Social Processes, 20–40. New York: Houghton Mifflin.
Zimmerman, D. (1998) Identities, context and interaction. In C. Antaki and S. Widdicombe (eds) Identities in Talk, 87–106. London: Sage.
Balint, M. (1957) The Doctor, His Patient and the Illness. Edinburgh: Churchill Livingstone.
Benwell, B. and Stokoe, E. (2006) Discourse and Identity. Edinburgh: Edinburgh University Press.
Berger, P. L. and Luckmann, T. (1967) The Social Construction of Reality. Harmondsworth: Penguin.
Bloor, M. J. and Horobin, G. W. (1975) Conflict and conflict resolution in doctor/patient interactions. In C. Cox and A. Mead (eds) A Sociology of Medical Practice, 271–284. London: Collier-Macmillan.
De Fina, A., Schiffrin, D. and Bamberg, M. (eds) (2006) Discourse and Identity. Cambridge: Cambridge University Press.
Elliott, P. (1972) The Sociology of the Professions. London: Macmillan.
Ferrara, K. W. (1994) Therapeutic Ways with Words. New York: Oxford University Press.
Frank, A. W. (1995) The Wounded Storyteller: Body, Illness and Ethics. Chicago, IL: University of Chicago Press.
Freidson, E. (1975) [1970] Profession of Medicine: A Study of the Sociology of Applied Knowledge. New York: Dodd, Mead & Company.
Foucault, M. (1972) The Archaeology of Knowledge (trans. A. M. Sheridan Smith). New York: Pantheon Books.
Giddens, A. (1991) Modernity and Self-Identity: Self and Society in the Late Modern Age. Cambridge: Polity Press.
Goffman, E. (1959) The Presentation of Self in Everyday Life. New York: Doubleday.
Goffman, E. (1961) Encounters: Two Studies in the Sociology of Interaction. Indianapolis, IN: Bobbs-Merrill.
Goffman, E. (1974) Frame Analysis. New York: Harper & Row.
Goffman, E. (1981) Forms of Talk. Oxford: Blackwell.
Halkowski, T. (1990) ‘Role’ as an interactional device. Social Problems 37 (4): 564–577. doi:10.1525/sp.1990.37.4.03a00100
Hall, C., Sarangi, S. and Slembrouck, S. (1999) The legitimation of the client and the profession: Identities and roles in social work discourse. In S. Sarangi and C. Roberts (eds) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings, 293–322. Berlin: Mouton de Gruyter.
Hall, S. and Du Gay, P. (eds) (1996) Questions of Cultural Identity. London: Sage.
Heritage, J. and Stivers, T. (1999) Online commentary in acute medical visits: A method of shaping patient expectations. Social Science & Medicine 49 (11): 1501–1517. doi:10.1016/ S0277-9536(99)00219-1
Hilbert, R. (1981) Toward an improved understanding of ‘role’. Theory and Society 10 (2): 207–226. doi:10.1007/BF00139892
Katz, E. and Danet, B. (eds) (1973) Bureaucracy and the Public: A Reader in Official-Client Relations. New York: Basic Books.
Linton, R. (1971) The status-role concept. In E. P. Hollander and R. G. Hunt (eds) Classic Contributions to Social Psychology, 111–114. New York: Oxford University Press.
McCall, G. and Simmons, J. L. (1978) [1966] Identities and Interactions: An Examination of Human Associations in Everyday Life. New York: The Free Press.
Mangione-Smith, R., Stivers, T., Elliott, M., McDonald, L. and Heritage, J. (2003) Online commentary during the physical examination: A communication tool for avoiding inappropriate antibiotic prescribing? Social Science & Medicine 56 (2): 313–320. doi: 10.1016/S0277-9536(02)00029-1
Maynard, D. (1991) The perspective-display series and the delivery and receipt of diagnostic news. In D. Boden and D. H. Zimmerman (eds) Talk and Social Structure, 164–192. Cambridge: Polity Press.
Mead, G. H. (1934) Mind, Self and Society. Chicago, IL: University of Chicago Press.
Mehan, H. (1983) The role of language and the language of role in institutional decision making. Language in Society 12 (2): 187–211. doi:10.1017/S0047404500009805
Merton, R. (1968) Social Theory and Social Structure, enlarged edition. New York: Free Press.
Mishler, E. G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
Park, R. E. (1950) Race and Culture. Glencoe, IL: The Free Press.
Parsons, T. (1951) The Social System. London: Routledge & Kegan Paul.
Pilnick, A. (2002) What ‘most people’ do. Exploring the ethical implications of genetic counselling. New Genetics and Society 21 (3): 339–350. doi:10.1080/14636770216003
Ragan, S. L. (1995) Educating the patient: Interactive learning in an OB-GYN context. In G. H. Morris and R. J. Chenail (eds) The Talk of the Clinic: Explorations in the Analysis of Medical and Therapeutic Discourse, 185–207. Hillsdale, NJ: Erlbaum Associates.
Ricoeur, P. (1992) Oneself as Another (trans. K. Blamey). Chicago, IL: University of Chicago Press.
Sarangi, S. (2000) Activity types, discourse types and interactional hybridity: The case of genetic counselling. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 1–27. London: Pearson.
Sarangi, S. (2007) Other-orientation in patient-centred healthcare communication: Unveiled ideology or discoursal ecology? In G. Garzone and S. Sarangi (eds) Discourse, Ideology and Ethics in Specialised Communication, 39–71. Berne: Peter Lang.
Sarangi, S. (in press) Owning responsible actions/selves: Parental accounts in the context of childhood genetic testing. In J.-O. Östman and A. Solin (eds) Discourse and Responsibility in Professional Settings. London: Equinox.
Sarangi, S. and Clarke, A. (2002) Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction 35 (2): 139– 171. doi:10.1207/S15327973RLSI3502_2
Sarangi, S. and Roberts, C. (eds) (1999) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings. Berlin: Mouton de Gruyter.
Sarangi, S. and Slembrouck, S. (1996) Language, Bureaucracy and Social Control. London: Longman.
Strong, P. M. and Davis, A. G. (1978) Who’s who in paediatric encounters: Morality, expertise and the generation of identity and action in medical settings. In A. G. Davis (ed.) Relationships Between Doctors and Patients, 48–75. Farnborough: Saxton House.
Thomas, J. A. (1986) The Dynamics of Discourse: A Pragmatic Analysis of Confrontational Interaction. Unpublished Doctoral Thesis. Lancaster University.
Turner, R. H. (1962) Role-taking: Process versus conformity. In A. Rose (ed.) Human Behaviour and Social Processes, 20–40. New York: Houghton Mifflin.
Zimmerman, D. (1998) Identities, context and interaction. In C. Antaki and S. Widdicombe (eds) Identities in Talk, 87–106. London: Sage.
Published
2011-03-27
Issue
Section
Articles
License
Equinox Publishing Ltd.
How to Cite
Sarangi, S. (2011). Reconfiguring self/identity/status/role: The case of professional role performance in healthcare encounters. Journal of Applied Linguistics and Professional Practice, 7(1), 75-95. https://doi.org/10.1558/japl.v7i1.75
