Imprecision in medical communication: study of a doctor talking to patients with serious illness

Uncertainty is believed to be a central feature in illness experiences. Con versations between a consultant haematologist and 61 seriously ill patients were transcribed, entered on a database and scrutinized for patterns of la nguage uncertainty by linguistic concordancing analysis. Transcripts were t hen discussed in detail with the haematologist, and techniques of protocol analysis were used to gain insight into his thought processes during consul tations. The main findings were that the doctor used many more expressions of uncertainty than did patients: that evaluative terms were widely used to reassure rather than to worry patients; and that patients and doctor toget her used certain key terms ambiguously, in a manner which allowed the docto r to feel that facts were not misrepresented while perhaps permitting the p atient to feel reassured.