The medium and the message

Communication between doctor and patient is examined in relation to ways of describing the institution of medicine, the rules of engagement between do ctor and patient, and the language they employ. Medicine and its institutio ns are presented in metaphorical terms, a theatrical taxonomy of consultati ons between patient and doctor is suggested; and patient-doctor communicati on is considered in the light of the pervasiveness of mistranslation. Becau se if is possible to invent a wide range of alternative metaphors for medic al institutions, to envisage many different sorts of dramatic possibilities in;the patient-doctor encounter, and to develop a respect for the particul arity of all language, optimism is expressed about the future of research, teaching and practice in doctor-patient communication. (C) 2000 Elsevier Sc ience Ireland Ltd. All rights reserved.