Volume 12, Issue 4
  • ISSN 1018-2101
  • E-ISSN: 2406-4238


This article deals with aspects of interaction between doctors and immigrant users whose native language is not Spanish (immigrant non-native speakers of Spanish: INNSS) in healthcare centers in Spain. The methodological focus is based on institutional conversation analysis following Drew and Heritage’s studies (Drew & Heritage 1992; Heritage 1997; Drew and Sarjonen 1997), and ethnographic research (Cicourel 1992). It is my intention to examine the characteristics and peculiarities -if any- of doctor-patient interaction when the participants are immigrants and non-native speakers of Spanish who are not fluent in the language of interaction, in this case Spanish. The study is based on quantitative and qualitative data which come from surveys and recordings carried out in healthcare centers in northern Madrid, Spain, during 2000 - 2001.


Article metrics loading...

Loading full text...

Full text loading...


  1. Atkinson, J. Maxwell , and Paul Drew
    (1979) Order in Court: The Organisation of Verbal Interaction in Judicial Settings. London: MacMillan.
    [Google Scholar]
  2. Atkinson, J. Maxwell , and John Heritage
    (eds.) (1984) Structures of social action: Studies in conversation analysis. Cambridge: Cambridge University Press.
    [Google Scholar]
  3. Atkinson, Paul
    (1999) Medical discourse, evidentiality and the construction of professional responsibility. In Srikant Sarangi & Celia Roberts (eds.), Talk, Work, and Institutional Order: Discourse in Medical, Mediation and Management Settings. New York: Mouton de Gruyter, pp. 75-106. doi: 10.1515/9783110208375.2.75
    https://doi.org/10.1515/9783110208375.2.75 [Google Scholar]
  4. Borrell I Carrio, F
    (1999) Manual de entrevista clínica. Barcelona: Doyma.
    [Google Scholar]
  5. Cicourel, Aaron
    (1987) Cognitive and organizational aspects of medical diagnostic reasoning. Discourse Processes10: 346-367. doi: 10.1080/01638538709544682
    https://doi.org/http://dx.doi.org/10.1080/01638538709544682 [Google Scholar]
  6. (1992) The interpenetration of communicative contexts: Examples from medical encounters. In Charles Goodwin & A. Duranti (eds.), Rethinking Context. Cambridge: Cambridge University Press.
    [Google Scholar]
  7. (1995) Medical speech events as resources for inferring differences inexpert-novice diagnostic reasoning. In U.M. Quasthoff (ed.), Aspects of Oral Communication. Berlin: W. de Gruyter.
    [Google Scholar]
  8. Conley, J.M. , and W.M. O ΄Barr
    (1990) Rules versus Relationships: The Etnography of Legal Discourse. Chicago: University of Chicago Press.
    [Google Scholar]
  9. Coupland, J. , J.D. Robinson , and N. Coupland
    (1994) Frame negotiation in doctor-elderly patient consultations. Discourse and Society5.1: 89-124. doi: 10.1177/0957926594005001005
    https://doi.org/http://dx.doi.org/10.1177/0957926594005001005 [Google Scholar]
  10. Coupland, N. , H. Giles , and J.M. Wiemann
    (eds.) (1991) Miscommunication and Problematic Talk. London: Sage.
    [Google Scholar]
  11. Diaz, Félix
    (1999) Asimetría profesional en la consulta de oncología: Algunas constricciones conversacionales de la clínica. Discurso y Sociedad 1.4: 35-68.
    [Google Scholar]
  12. Drew, Paul , and Marja-Leena Sorjonen
    (1997) Institutional dialogue. In Teun A. Van Dijk (ed.), Disourse as Social Interaction. Londres: Sage, pp. 92-118.
    [Google Scholar]
  13. Drew, Paul , and John Heritage
    (eds.) (1992) Talk at work. Cambridge: Cambridge University Press.
    [Google Scholar]
  14. Fisher, S
    (1983) Doctor talk/patient talk. In S. Fisher & A.D. Todd (eds.), 1993. The Social Organization of Doctor-Patient Communication. 2nd edition a edc. Norwood, NJ: Ablex.
    [Google Scholar]
  15. Frankel, R.M
    (1990) Talking in interviews: A dispreference for patient-initiated question in physician-patient encounters. In G. Pasathas (ed.), Interaction Competence. Washington DC: University Press of America, pp. 231-62.
    [Google Scholar]
  16. Giles, H. , and P. Powesland
    (1997) Accommodation theory. In N. Coupland and A. Jaworski (eds.), Sociolinguistics. A Reader Coursebook. London: Routledge, pp. 232-239.
    [Google Scholar]
  17. Hak, Tony
    (1994) The interactional form of professional dominance. Sociology of Heart and Illness16: 469-488. doi: 10.1111/1467‑9566.ep11347541
    https://doi.org/10.1111/1467-9566.ep11347541 [Google Scholar]
  18. Heritage, John
    (1997) Conversation analysis and institutional talk. In David Silverman (ed.), Qualitative Research: Theory, Method and Practice. Londres: Sage, pp. 161-182.
    [Google Scholar]
  19. Heritage, John , and Marja-Leena Sorjonen
    (1994) Constituting and maintaining activities across sequences: and-prefacing as a feautre between health visitors and first time mothers. Language in Society23.1: 1-19. doi: 10.1017/S0047404500017656
    https://doi.org/http://dx.doi.org/10.1017/S0047404500017656 [Google Scholar]
  20. Heritage, John , and D. Greatbach
    (1991) On the institutional character of institutional talk: The case of news interviews. In D. Boden & D. Zimmerman (eds.), Talk and Social Structure. Studies in Ethnomethodology and Conversation Analysis. Cambridge: Cambridge University Press, pp. 359-417.
    [Google Scholar]
  21. Heritage, John , and A.L. Roth
    (1995) Grammar and institution: Questions and questioning in broadcast media. Research on Language and Social Interaction 28.1: 1-60. doi: 10.1207/s15327973rlsi2801_1
    https://doi.org/http://dx.doi.org/10.1207/s15327973rlsi2801_1 [Google Scholar]
  22. Long, A
    (1983) Linguistic and conversational adjustments to non-native speakers. Studies in Second Language Acquisition 5.2: 177-193. doi: 10.1017/S0272263100004848
    https://doi.org/10.1017/S0272263100004848 [Google Scholar]
  23. Maynard, D.W
    (1984) Inside Plea Bargaining: The Language of Negotiations. New York: Plenum Press. doi: 10.1007/978‑1‑4899‑0372‑3
    https://doi.org/10.1007/978-1-4899-0372-3 [Google Scholar]
  24. (1989) On the ethnography and analysis of discourse in institutional settings. Perspectives on Social Problems1: 127-146.
    [Google Scholar]
  25. (1992) On clinicians co-implicating recipients΄ perspective in the delivery of diagnostic news. In Paul Drew & John Heritage (eds.), Talk at Work. Cambridge: Cambridge University Press.
    [Google Scholar]
  26. Mishler, Elliot
    (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
    [Google Scholar]
  27. (1994) The struggle between the voice of medicine and the voice of the lifeworld. In P. Conrad & R. Kern (eds.), The Sociology of Health and Illness: Critical Perspectives. New York: St. Martin’s, pp. 288-300.
    [Google Scholar]
  28. Sarangi, Srikant , and Celia Roberts
    (1999) Talk, work and institutional order. Berlin: Mouton de Gruyter. doi: 10.1515/9783110208375
    https://doi.org/http://dx.doi.org/10.1515/9783110208375 [Google Scholar]
  29. Silverman, David
    (1987) Communication and Medical Practice: Social Relations in the Clinic. London: Sage.
    [Google Scholar]
  30. Valero Garcés, Carmen
    (2002) Análisis conversacional de las interacciones entre proveedores de servicios y usuarios inmigrantes en los centros de salud. Oralia 52002: 265-296.
    [Google Scholar]
  31. Ventola, E
    (1987) The structure of social interaction: Systematic approach to the semiotics of service encounters. London: Francis Pinter.
    [Google Scholar]
  32. West, C
    (1984) Routine complications: Troubles with talk between doctors and patients. Bloomington, IN: Indiana University Press.
    [Google Scholar]
  33. (1990) Not just ‘doctors’ orders. Discourse & Society1.1: 85-112. doi: 10.1177/0957926590001001005
    https://doi.org/10.1177/0957926590001001005 [Google Scholar]
  34. Wodak, R
    (1996) Disorders of discourse. London: Longman.
    [Google Scholar]
  35. Zuengler, John
    (1991) Accommodation in native-non-native interactions: Going beyond the 'what' to the 'why' in second language research. In H. Giles , J. Coupland & N. Coupland (eds.), Contexts of Accommodation. Cambridge: Cambridge University Press, pp. 223-244. doi: 10.1017/CBO9780511663673.007
    https://doi.org/10.1017/CBO9780511663673.007 [Google Scholar]
This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error