Biomedical Engineering Reference
In-Depth Information
2
Learning to talk and talking
about talk
Professional identity and
communicative technology
Lars-Christer Hydén and
Antje Lumma
Introduction
During the last fi fty years major changes have taken place in medical
knowledge, treatment and care, as well as in its organization. These changes
concern both the medical practices and the social and cultural conditions of
the health care system.
David Mechanic, an American medical sociologist, points out that the
transformation in medicine has come not only from the introduction of new
drugs, imaging devices, surgical tools and other biomedical technologies,
but also from 'changing social and organizational technologies' (Mechanic
2002). We would like to point out that one such new social technology is
the development of communicative technologies for the dialogue between
doctors and patients, especially in the medical interview.
We do not often think of communication and social and verbal interaction
in terms of technology, and especially not in the medical setting where ideas
like compassion and active listening are considered central. Nevertheless,
not only can ways of talking be learnt, but ways of talking strategically can
also be learnt. In this context we can think of technology as a set of strategies
used in order to produce certain ends or attain certain goals. Not only do
clinical professionals like medical doctors, psychologists, psychotherapists
and social workers learn these types of communicative strategies, but lawyers,
police offi cers and members of other professions do as well. They also learn
to how to
violate
and strategically use everyday conventions of talk in order
to be able to pursue their professional goals, irrespective of their own and
their clients' 'true' motivations.
In this chapter we discuss the development and use of communicative
technology in modern medicine, focusing on the relationship between
the medical doctor and the patient. We are especially interested in factors
both
inside
and
outside
medicine that have affected this development, as
well as how medical students learn to use modern medical communicative
technologies and ideologies. Modern medicine is characterized by new types
