Negotiating Power Dynamics in Medical Encounters as Private Sector “Business Interactions"

The dynamics of interaction, whether symmetrical or asymmetrical, are fundamental aspects of communication across diverse settings. The power dynamics of medical encounters adopt various different stances including the traditionally held view whereby a typical doctor-patient interaction is a situation of control to the “expert patient”, who presents as literate and able to negotiate a more equal interactional position within the encounter.
Considering that medical encounters also take place within institutional settings, the dynamics of how professional communication is enacted also form part of the interaction at play. While health communication within an institutional setting has been amply addressed, paid private sector consultations have been dealt with to a lesser extent.
Hence, the current paper aims to investigate the extent to which paying for a medical consultation within the private sector can be classified as a “business” exchange and whether this may (or may not) bear influence on the power dynamics of the interactions at play. The study considers live recorded first consultations within the context of cosmetic surgery private
practice in the UK. Corpus linguistic methodologies are applied in order to identify the semantic fields related to exchange of money and paying for the service along with close reading discourse analysis for selected excerpts in order to triangulate data and provide a complete data analysis with contextualised examples.