Doctor, do you speak speak English? An analysis of pragmatic strategies to achieve mutual understanding during GP consultations in English as a Lingua Franca in the Netherlands

Abstract

In a world of rapid trends in immigration and globalization, healthcare professionals are often caring for patients from diverse cultural and linguistic backgrounds (Nash, 2014). In the Netherlands, government funding for professional interpretation for non-Dutch speaking patients in health care was cut in 2012 (Kwant, 2017). Since then, health care professionals and non-Dutch patients must fall back on alternative means to bridge the linguistic and cultural barriers they face during medical consultations. One such method is the use of English as a Lingua Franca (ELF), whereby it is not the native language of one or both interlocutors (Cogo, 2009; Jenkins, 2011). Since previous research on ELF in the medical context appears limited, the current research aim was to establish the communicative characteristics of GP consultations in ELF in the Netherlands. This thesis builds on a body of research that has investigated the use of certain pragmatic strategies which appear to facilitate communication in ELF. The current study investigates whether these pragmatic strategies are used by doctor and patient. Next to facilitative characteristics, it was investigated which characteristics of the ELF consultations hindered doctor-patient communication. Misunderstanding occurred infrequently in the ten ELF consultations recorded for this study, and it was confirmed that pragmatic strategies facilitate communication. However, when misunderstanding arose, it was usually repaired by employing the aforementioned pragmatic strategies. The current study contributes to research on ELF communication and intercultural doctor-patient communication. It further stresses the importance of actively using pragmatic strategies to enhance communication, as well as expressing intercultural awareness to establish common ground between doctor and patient.