The paradoxes of communication in the dental clinic: Luhmann's form analysis and the clinical system
Oral health and Development University of Sheffield Sheffield, UK
Oral Health and Development University of Sheffield Sheffield, UK
Contemporary conversation studies have increasingly accounted for the complexity of meaning construction in communication and characterised by both conceptual and linguistic rigor. The paper makes a strong case for a methodologically novel approach to the analysis of communication originated in systems theory and discussed the possible cross-fertilisation between conversation analysis and form analysis. This framework originates in the systems theory and form analysis of Luhmann (1995, 1999, and 2001), and later in the works of Andersen (2003, 2007). Form analysis has been relatively unknown and detached from the Anglophonic sociologists until recently. Some new research demonstrated its empirical applications to communication research (Schneider, 2000; Baraldi & Gavioli, 2006), however, the benefits of potential synthesis should also be carefully explored.
The paper aims to contribute into the understanding of the semantic and communicative complexity of clinical encounters and to explain the tensions between medical professionals and patients from the a new analytical framework. This methodology adds to the insights about the systemic discourse of medicine, but also allows exploring communicative contingency in clinical (dental) encounters.
Data are collected through 36 observations of dentist-patient consultations and interviews with 5 dentists and 20 patients in primary and secondary care. The results of form analysis suggest 14 forms of functionally specific communication which described the semantics of the dental clinic. These forms explain the complex, intricate relations between what dentists and patients actualised as important for them.
The findings sensitize the paradoxes of communication in clinical settings by exploring the connections with the semantics of the clinical system. Semantic power of the dental clinic discussed as different to structural discourses of medicine and dramaturgy of language games, yet, as imposing connectivity on the communication in the encounters.