Analysis: discourse styles in MedQuest and JustAnswer
Posted: April 7, 2011 Filed under: SE1342 | Tags: discussion, justanswer, medquest, power in discourse, SE1342, self-presentation Leave a comment »Overall, there were mixed results for the proposed hypothesis:
At first glance, qualified doctors in JustAnswer appeared to display more powerlessness than laypersons in MedQuest, which would suggest that the above hypothesis is incorrect. However, there was dramatic variation in the distribution of strategies used between the two groups.
For MedQuest, there were some distinct similarities with Morrow’s (2006) findings on NetDoctor, in that there was a relatively high presence of powerless features that indicated solidarity building. This was mainly in the form of disclaimers and personal accounts, some of which contained both, for example:
Example 1
“Not-a-doctor advice! Just the owner and operator of a uterus!…
…My mother and I couldn’t be more different, reproductively speaking. She’s always had an easy time of it, whereas I take after my aunt, her sister, who… hasn’t. Heredity’s funny like that, except I’m not laughing because I got the short end of the stick. 
”
(Appendix 1: topic 1, reply 1 (User1), my italics)
User1’s response is plainly indicative of an attempt to build solidarity with the user seeking help; the disclaimer reduces her to a layperson’s status by proclaiming that she is just ‘the owner of a uterus’, identical to her addressee. The use of humour, which is made unambiguous with the use of a winking ‘;-)’ emoticon reduces differential power relations between her and the addressee, according to Vaughan’s (2008:105) study of institutional settings (which is analogous to MedQuest’s ‘environment’, due to the social roles involved (Agar 1985, cited in Mayr 2008:4)).
Despite an apparent majority of users taking the ‘solidarity’ approach in their advice, there were findings that differed from Morrow’s (2006); these were a minority of users that appeared to seek higher social distance and power. One user in particular (‘User2’) consistently demonstrated this:
Example 2
“…If you can’t find anything that way, call around to dermatologists in your area. Tell them you’re uninsured (most doctors charge uninsured patients less), ask how much they charge for a punch-biopsy, and ask if they do payment plans or sliding-scale payment. You might be able to find someone who’s willing to work with you so that you can get the care you need.”
(Appendix 1: topic 4, reply 1 (User2), my italics)
There is a distinct lack of powerless features in User2’s language, and there are instances of impersonal direct imperatives (‘tell them – ask them’) which reinforces their authority (Fairclough 2001:39). We can also comment on the lexical complexity, as they use institutional lexemes such as ‘punch-biopsy’ and ‘dermatologist’. This use of vocabulary and grammar is indicative of a speaker’s high power and authority (Bradac et. al 1988, Thomas and Wareing 1999, cited in Bradac and Giles 2005:212), and was much more evident in professional advice on JustAnswer, for example:
Example 3
“Warm up effectively before activity and exercise.
Consult a physician for an electrolyte/metabolic profile and further evaluation if the shaking does not resolve with home conservative therapy.
Hope this helps.”
(Appendix 2: topic 11, reply 1 (Doctor7), my italics)
Moreover, User2, who showed particular preference for authority in their discourse, also favoured the use of ‘if X, Y’ conditionals. Example 2 exhibits this, the function being an indirect imperative. It has been argued that this form of imperative is more powerful than if it were direct, since the addressee will be more likely to comply. This strategy is common in doctors’ discourse (Ferguson 2001, cited in Hewings and Hewings:113-114), and was also typically seen in the advice given on JustAnswer, which supports this view. A possible complication concerning User2 is, however, that their discourse style is due to an achieved hierarchy over the other users in the group due to apparent high frequency of posting, and comparatively superior medical knowledge (Mesch 2007:239)
Users in MedQuest who favoured powerful discourse did use disclaimers to defer responsibility of their advice, but these retained a sense of medical qualification, such as using their dermatology professor’s expertise in Example 2. One instance in a response introduction, ‘Coming from a pharmacy student…’ (Appendix 1: topic 2, reply 1 (User4)) seemed to simultaneously reject responsibility through an unprofessional student identity, but usually not completely like other users may, through the elaboration that they are a student of a relevant discipline.
The advice given by professionals on JustAnswer seemed to fit with the hypothesis. There was a distinct lack of powerless language in terms of hedging, inclusive pronouns and personal accounts (Holtgraves 2010:1401; Brashers and Adkins 1995:301). Interestingly, however, there were significantly more good luck endings and displays of empathy than in MedQuest, which Morrow (2006:542-3) describes as constructions of solidarity and power deference.
Example 4:
“…Drinking medications with less water is again not a much concern but water otherwise is good for health and should be taken as much as possible, atleast 6 glass a day. But medications should be taken on empty stomach except those with instructions to do so.
If any query please ask. i will be glad to help you.
I wish that you remain healthy always.
Please click ACCEPT if i have answered your question.
Regards
Dr XXXXX”
(Topic 13: reply 1 (Doctor5), my italics)
Empathy strategies usually took the form of wishing for the addressee’s good health, or hope that the advice has helped them. Wishing good luck may also have a similar effect, as it also projects the doctor as a ‘caring individual’. Though on the surface these strategies may appear to subvert their authority, this may be a useful technique for gaining compliance (in the form of taking advice, or giving positive feedback or payment on the website) and is therefore a mitigated display of power (Pawlikowska et al. 2007:202). Polite forms were often used prior or during a request for feedback which suggests an influence to comply. Strategies for politeness or empathy were always separated from the advice content, preserving their authority in the ‘goal-orientated’ part of the text.
References:
Fairclough, N. (2001). Language and Power. 2nd ed. Harlow, Essex: Pearson Education Ltd.
