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Angie Quintero

Professor Thames

ENC 1102: Composition II

11 April 2021

Learning the Language: The Genres and Lexis of a Medical Discourse Community

Introduction

In a medical discourse, communication between each medical professional is vastly vital

for the general care of patients, whether it’s through paper or the electronic documentation of a

patient’s history such as medical case reports and discharge summaries, it is crucial that the

communication between physicians is clear and concise to ensure the success of the medical

discourse. All of the sources covered in this research speak on the topic of effective

communication in medical discourse, they discuss that for the discourse community to succeed,

the members must utilize their genres and lexis appropriately. Nevertheless, the outlier source is

“Discourse Communities and Communities of Practice: Membership, Conflict, and Diversity” by

Ann Johns as it doesn’t acknowledge medical discourse communities, it more so focuses on the

difficulties and conflicts that exist within academic discourse communities. Nonetheless, it’s still

useful for background knowledge on discourse communities. This research considers the

different genres and lexis including medical case reports, discharge summaries, and medical

terminology among others used in a medical discourse by its members to reach their established

common goal which is to provide the best patient care. Also, it furthers the important role genres

and lexis play as they allow and promote the means of functional communication between

physicians. One source, in particular, The Rhetoric of Medical Discourse: An Analysis of the

Major Genre by Karin Yanoff, gives insight into the major genres of the medical discourse, for
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this research, evaluating the different genres is pivotal to understand how they may or may not

work to facilitate communication among members. In addition, the source “Medical Discourse:

A Glimpse into Communication in a Health Care Environment” by Matthew Ennis differs in the

fact that it identifies medical lexis as a successful method of communication, stating that “as a

way to save time and simplify tasks, acronyms [and] other medical slang, are invented,”

emphasizing the importance of abbreviations and specialized vocabulary, while other sources

such as “Effective Physician-to-Physician Communication: An Essential Ingredient for Care

Coordination” by Diane Shannon argue otherwise, still, this source is relevant and critical to my

research since I plan on comparing what truly aids the process of facilitating communication

among members that work in a medical setting (7). Additionally, Haran Ratna in his article, “The

Importance of Effective Communication in Healthcare Practice,” illustrates the importance of

effective communication when delivering healthcare. Although he doesn’t discuss genres of

discourse communities, he discusses the value of communication and its ability to produce better

health outcomes which is a defining characteristic that exists within discourse communities. It

relates to my research since I plan to explore the different genres and lexis used by physicians to

effectively communicate amongst each other and how productive it is in reaching their common

goals. Moreover, in the source “Stylistic Features of Case Reports as a Genre of Medical

Discourse,” Yuliia Lysanets establishes the lexical and grammatical aspects of constructive

medical case reports. She does so to provide guidelines on how to construct the most useful and

functional medical case reports, which she argues will promote effective communication

amongst medical professionals. I can include her insight on medical case reports in my own

research of the medical discourse community. Through this research, I intend to provide

awareness for members of a medical discourse community on the factors of communication by

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conducting a combination of interviews, surveys, and textual/genre analysis. Communication

plays a leading role in everything that occurs in a medical setting and comprehending its

influential nature is pivotal when realizing the best outcomes.

Methodology

For the first method, I conducted a virtual interview with a specialist physician who is a

member of the Palm Beach Accountable Care Organization (PBACO). He is currently a part of

the PBACO medical discourse community and has insight into the use of language and texts

used in medical discourse, all of which are useful when determining the different genres and

lexis that exist within the medical discourse and how they are used. While creating the questions

for the interview, I took into consideration communication within a medical discourse

community, primarily I tried to make sure that my questions focused on igniting the topic of

medical jargon and texts used by him and his coworkers. Below I have attached my CITI

certificate indicating I have taken the human responsible conduct of research course meaning I

am qualified to perform this interview.

For my second method, I created a survey on SurveyMonkey and posted it on Reddit and

other online forums. Through this survey, I worked to reach members pertaining to a medical

discourse community in order to gather information relating to their usage of texts and the

everyday language they have adopted while working and communicating with their coworkers.

With this information, I demonstrated how genres and lexis are in fact used to facilitate

communication and how dependent/independent the participants are in terms of relying on those

genres and lexis. In the survey conducted, there were 15 participants. With the open-ended

questions, there were multiple comparable answers, so I separated the ones that were similar and

grouped them as one answer, there were about two to three different answers.
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For my other two methodologies, I performed a textual and genre analysis on a few

primary sources. For the textual analysis, I chose the source, “Learning the Language,” a creative

writing piece by Perri Klass which covers the use of language and texts in medical discourse.

Additionally, Klass also speaks on the specialized lexis used by physicians to help mediate their

activities. This short story is located in the WAW textbook and it reflects how communication

affects the workplace for physicians, which is what I discuss in my research. For the genre

analysis, I selected two examples of documents used in the medical discourse that were given to

me by the specialist physician which I interviewed. I received an example of a patient history

form along with normal notes they pass around on an everyday basis. By performing a genre

analysis, especially on the notes, I was able to detect how influential they were in achieving the

common goals of the discourse community.

Results

The responses for the survey were collected through survey monkey and Reddit, and are

recorded in Appendix C. Through the survey I created and posted on multiple online forums, I

received data claiming that genres and medical jargon do in fact play a foremost part in allowing

for prime communication between physicians. Over 80 percent of the participants claimed that

the most common text they used in their medical discourse community on an everyday basis

were patient notes, and following the notes were discharge summaries with 72 percent and

patient history forms with 70 percent. More than 90 percent of the participants also claimed that

they used medical jargon to communicate between physicians and nurses. There were a range of

answers for the open-ended question, however, after coding and separating the answers, most

participants stated that in the field of medicine, verbal and written communication played a
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highly important part in administering effective care to their patients, which in this case is their

main goal. Essentially, the ability to communicate efficiently and effectively is the basis for the

success or failure of the medical discourse community as a whole.

The transcript of the interview was recorded and is located in Appendix A. Every major

profession has its organizations, its practices, its textual conventions, and its genres. A discourse

community is a group of people involved in and communicating about a particular topic, issue,

or in a particular field. Jorge Quintero became involved in the PBACO professional discourse

community, a group in which people get involved to maintain ties as a result of their profession

(Johns, pg.347). As in other professions, the doctors that pertain to this group have a base of

expertise, values, and expectation that they use to facilitate communication. Quintero

acknowledged his use and understanding of medical jargon and established it as important lingo

used to facilitate communication among members. He said:

“We are dealing with human lives and dealing with the fact that we have a speedy work

environment, and I think the main issue is that we must get our point across as fast as possible

and as accurate as possible, which is why we try to stay within the same lingo.”

Without this established jargon, the discourse community would not be able to

communicate successfully. A fast-paced work environment requires accuracy and through their

usage of common medical terminology and abbreviations, communication among members is

rapid and accurate. Good communication ultimately leads to the success of the discourse

community. He states:
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“We have communicative priorities such as making sure we all know the history of the patient

before going into surgery so that if any complications arise we can easily resolve them. We also

need to communicate these things so that we ensure we follow through with administering the

correct amount of anesthesia to the patient. So yes, communication plays a major role in

achieving our main goal of caring for the patient, without communication we wouldn't be as

successful in achieving our main purpose as doctors.”

After the interview, it was clear that verbal communication between physicians wasn’t

their only form of communication, written communication also allowed for them to

communicate certain things such as the different amounts of dosages, prescribed medication, and

even patient history forms which included details about the patient along with many other things.

Quintero mentioned that he mainly used patient history forms and general patient notes- quick

notes about patients.

The medical discourse community contains many rhetorical genres that work to carry out

the community’s goals. One genre in specific is the patient history form. The main objective of

the patient history form is to identify any relevant medical experiences the patient has previously

confronted. It includes an informative section that mentions the patient's name, weight, height,

age, etc. It also includes past surgeries, illnesses, and medications along with any known

allergies and other known conditions that the patient might have. Patient history forms are

comprehensive and accurate, they contain detailed information about the patient to ensure quality

care. They are used to help diagnose the patients. The primary audience would be physicians and

nurses. Physicians rely heavily on patient history forms to make sure they diagnose their patients

correctly and to corroborate that they’re not prescribing something that may in fact worsen the
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patient’s state. In Jorge’s case, he must take into consideration the patient’s weight to accurately

insert the precise amount of anesthesia.

Another rhetorical genre used in the medical profession involves patient notes, patient

notes are less extensive and more general. They are notes that contain information regarding the

patient’s treatment. It could be simply a note of the medication the patient is being prescribed

and along with it the time that it would be given to them. Since they are more simple, they're

more often used by medical professionals as they are regularly in a rush and need an efficient

way to jot information down. Although they are simple, they’re still very precise as they still do

contain vital information about the patient’s treatment. From the samples of patient notes I

looked at, I noticed that they followed a similar format- containing chopped sentences, bulleted

notes, and time stamps. Most of the language used contained medical terminology and codes.

They also had the patient's room number alongside whatever the note was about. The audience

for patient notes would be physicians and nurses. These were notes that were routinely passed

around and transcribed to a more official document, such as the discharge summary after they

served their purpose.

The creative piece I chose to analyze was written by Perri Klass, a medical student at the

time, who wrote of her experience as a student entering a medical setting. This piece in specific

illuminates the drawbacks of medical jargon. Perri elaborates on the usage of medical jargon as it

enables doctors to communicate effectively in the hospital and also maintain some distance from

the patients. She mentioned that medical jargon allowed the doctors to speak amongst themselves

without the patient understanding, which in a way is both a negative and positive aspect, as it

may reduce the emotional impact for the patient or it may frustrate the patient as they are not

understanding something that may be crucial as to how they go forward with their health. Klass
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however, goes into depth stating that she struggled to pick up the patterns of speech and the

grammatical conventions used by doctors, nevertheless, it was a form of language that she was

required to learn in order to communicate amongst the medical professionals.

Discussion

Over the course of my research, I looked over the different languages and texts used by

medical professionals and analyzed how they worked to meet the goals established for the

discourse community. Focusing on an interview I conducted with a specialist physician who

spoke on his experience as a physician in his own medical discourse community, I realized the

significance of communication in his particular discourse community, similar to Haran Ratna

article “The Importance of Effective Communication in Healthcare Practice,” Quintero also

mentions that without communication they would not be able to meet their purpose as doctors

because it is through communication that they get things done. For instance, the nurse takes the

vitals, then he or she needs to communicate this either orally or in a written form so that then the

doctor can come and further analyze and come up with a plan of treatment for the doctor.

Especially in a setting so chaotic like a hospital, communication isn't just between physicians,

there is a long line of communication that starts with the person checking in the patient, it is

more than important for everything that is being communicated to stay as accurate as possible to

ensure the best care for the patient. Without the communication between nurse and doctor, the

patient would not receive ethical care.

After analyzing the results gathered from the survey, it was noticeable that many genres

and specialized lexis are often used between medical professionals to facilitate communication.

The notes, in particular, are the most common texts used, since they are less complex and are

easier to understand and communicate with, comparingly Karin Yanoff in, The Rhetoric of
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Medical Discourse: An Analysis of the Major Genre, researched the major genres used in

medical discourse, he discovered that the least extensive formats were the ones commonly used

by medical professionals and those texts in specific were the ones that permitted physicians to

quickly care for their patients.

Following the textual analysis of Perri Klass’s creative story, it came to my attention that

medical jargon - a variation of specialized terminology- is often used by physicians, to a point

that they depend on it to communicate amongst each other. Nevertheless, a hospital setting does

not only have doctors but also has patients, patients that may find that language confusing and

perplexing. Its key to note that the patients play a major role in the community’s success and as a

result, they must be considered. This differs from, “Medical Discourse: A Glimpse into

Communication in a Health Care Environment” by Matthew Ennis who identifies medical lexis

as a successful method of communication, stating that “as a way to save time and simplify

tasks.” This research shows that communication between physicians is more than central for the

progress of the community, yet, communication between physician and patient should not be

overlooked as it’s the piece that establishes the overall success.

Conclusion

From all the research I conducted, I am able to conclude that there needs to be clear and

concise communication between medical professionals in order for their discourse community to

be successful. While medical jargon is an efficient method of communication, it provides an

opportunity for mistakes and misunderstandings, especially if it’s said verbally. Medical Jargon

could lead to miscommunication and possibly to ineffective medical care. It's clearly used by

many physicians, and I would say it is effective to include throughout the documentation, as that
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will most likely only be read by medical professionals, however, medical jargon used between

physician and patient, like Klass mentions, could be misleading language. The different genres,

however, have shown to be great forms of communication used between medical professionals,

as most documents are very precise and efficient. If physicians relied less on medical jargon,

they could build stronger relationships with their patients and in turn allow for a greater success

of the medical discourse community.

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Works Cited

Ennis, Matthew. “Medical Discourse: A Glimpse into Communication in a Health Care

Environment.” Sullivan Files, 15 Sep. 2004.

http://sullivanfiles.net/WID/assignments/discourse_field/ennis_discourse.pdf

Johns, Ann M. “Discourse Communities and Communities of Practice: Membership, Conflict,

and Diversity” Writing About Writing: A College Reader for the University of Central

Florida, Edited by Elizabeth Wardle and Doug Downs, 4th Edition, Bedford/St.Martins,

2020, pp. 560-578.

Klass, Perri. “Learning the Language” Writing about Writing: A College Reader for the

University of Central Florida by Elizabeth Wardle and Doug Downs, 3rd edition,

Bedford/St.Martins, pp.368- 373.

Lysanets, Yuliia, et al. “Stylistic Features of Case Reports as a Genre of Medical Discourse.”

Journal of Medical Case Reports, vol. 11, no. 1, Mar. 2017. EBSCOhost,

doi:10.1186/s13256-017-1247-x.

Quintero, Jorge. Personal Interview. 01 March 2021.

Quintero, Jorge. Medical Documentation. 02 March 2021.

Ratna, Haran. “The Importance of Effective Communication in Healthcare Practice.” Harvard

Public Health Review, vol. 23, 2019, pp. 1–6. EBSCOhost,

search.ebscohost.com/login.aspx?

direct=true&db=edsjsr&AN=edsjsr.48546767&site=eds-live&scope=site.

Shannon, Diane. “Effective Physician-to-Physician Communication: An Essential Ingredient for

Care Coordination.” Physician Executive, vol. 38, no. 1, Jan. 2012, pp. 16- 21.
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EBSCOhost, search.ebscohost.com/login.aspx?

direct=true&db=buh&AN=70548724&sit=eds-

live&scope=site.

Yanoff, Karin Lindblad. The Rhetoric of Medical Discourse: An Analysis of the Major Genres.

Dissertation Abstracts International, vol. 49, no. 10, University of PennsylvaniaProQuest,

Apr. 1989, pp. 355-396. EBSCOhost, search.ebscohost.com/login.aspx?

direct=true&db=mzh&AN=1989075656&site=eds-live&scope=site.
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Appendix A

Interview Transcript:

In case you are unfamiliar with the term” discourse community,” according to John Swales, it

can be best understood as a “group of people who share a set of discourses, known as basic

values and assumptions, and ways of communicating about those goals.” For example, a

discourse community could be a group of emergency room nurses as they have a common goal,

alike values, and have a specialized vocabulary. Consider this definition while I move forward

with the interview.

Interviewer: Are you a part of a discourse community? If so, what discourse community are you

a part of? (Introductory questions)

Interviewee: Hello I am Dr. Jorge Quintero and I am an anesthesiologist, I specialize in hip

replacements, knee replacements, and any other elective surgeries. I'm currently a member of the

Palm Beach Accountable Care Organization and have been so for almost five years. I would

consider this a medical discourse community since we are a group of specialist physicians

ranging from the anesthesiologist to cardiologist that work in medical settings and share the same

goals and language among other things.

Interviewer: What kind of texts are involved in your discourse community/group? Such as

discharge summaries, consultation letters, case reports, etc. Are there any other methods of

communication used by members such as evolving genres including emails and telemedicine?

Interviewee: We use patient history forms and discharge summaries every day to gather

information on our patients and then release them after caring for them. We also use emails and

online resources to communicate amongst each other, it’s our method of communication when a

member is not in sight or is located elsewhere. As a result of COVID we have transitioned to

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using telemedicine as a form of interacting with patients, however, being an anesthesiologist I

don't interact as much with patients to have one on one conversations with them through a

platform.

Interviewer: How many different people have likely seen those texts?

Interviewee: All members of our discourse community use these texts, they are vital to our

success as doctors as they help us communicate what's wrong with our patients and how we will

follow through with their care.

Interviewer: How are those texts used to facilitate communication among the members of your

group?

Interviewee: They are used to efficiently communicate things such as the patient history form

which indicates information about the patient.

Interviewer: Are there certain ways that members are expected to use these texts?

Interviewee: We have a standard that we follow, and so we all speak and write the same

language especially throughout these texts in order to accomplish our goal of caring for the

patient.

Interviewer: How do you communicate with your co-workers? Are there any special medical

terminologies or abbreviations that you and your coworker use amongst each other?

Interviewee: We have to be able to communicate with one another as efficiently as possible so

we tend to use common medical terminology and abbreviations in our everyday lingo to be able

to do so. Amongst each other, we use abbreviations for certain surgeries along with some

procedures to get everything done efficiently and of course effectively.

Interviewer: What do these terms mean? Why do you use those terms?
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Interviewee: When it comes to our patient assessments, we have a standard that we follow, and

so we all speak and write the same language in order to accomplish our goal of caring for the

patient. We are dealing with human lives and dealing with the fact that we have a speedy work

environment, and I think the main issue is that we must get our point across as fast as possible

and as accurate as possible, which is why we try to stay within the same lingo.

Interviewer: What are some of the goals of your group? What do you do to achieve those goals?

Interviewee: The main goal for our group is to make sure that the patient basically comes out

alive and to provide the best possible care for their wellbeing and overall health.

Interviewer: Does communication play a role in achieving those goals? Is it a significant role?

Interviewee: We do have communicative priorities such as making sure we all know the history

of the patient before going into surgery so that if any complications arise we can easily resolve

them. We also need to communicate these things so that we ensure we follow through with

administering the correct amount of anesthesia to the patient. So yes, communication plays a

major role in achieving our main goal of caring for the patient, without communication we

wouldn't be as successful in achieving our purpose as doctors.

Interviewer: How important is effective and efficient communication among the members of

your group?

Interviewee: Without effective and efficient communication we would not be able to do most of

the things we do to ensure we have a smooth day at work. By no means is it always smooth to

work in a medical environment, but I can tell you that communication plays a key role in

allowing for the best possible outcomes. For instance, if there is a patient that has an allergic

reaction to a medication that is communicated to a nurse but then is not again communicated to

the doctor then we could accidentally harm the patient if we were to prescribe them that
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medication. Also through communication, we are able to get things done at a faster pace, seeing

as though we have to work fast in this setting especially when they are emergencies. As doctors,

we carry the responsibility of healing patients and ensuring they have the best possible health

outcomes which are only possible through communication.

Interviewer: Do you have a sample of any of those texts you mentioned before that you’d be

willing to share with me?

Interviewee: Yes, I would be willing to share with you some notes that I have collected to show

you certain things that we communicate. I also have an example patient history form if you

would like to take a look at it, it would obviously not contain the patient’s personal information.
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Appendix B

Survey Questions:

This survey is meant for participants that are a member of a medical discourse community and

are over the age of 18. If you do not meet BOTH of those requirements then you may not be a

participant in this research. This survey aims to collect data on active members of medical

discourse communities and their personal experiences with languages and text used in the

medical setting. Therefore, If you do not fit this role, do not attempt to take this survey.

1. Are you over 18 years of age?

a. Yes

b. No

2. Are you a part of a medical discourse community? This includes medical professionals

such as physicians, special physicians, nurses, etc.

a. Yes

b. No

3. What are the most common genres/text used in your medical discourse community on an

everyday basis? Choose all that apply.

a. Discharge summaries

b. Consultation letters

c. Case reports

d. Patient-history forms

e. Medical reports

f. Progress notes

g. Other: write the ones that apply to you but are not listed
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4. How effective are genres/text (which you chose in the previous question) in promoting

the best health outcomes for patients?

a. Highly effective

b. Effective

c. Moderately effective

d. Not effective at all

5. Are there any particular lexis or jargon used in your field?

a. Yes

b. No

6. If so, is that language often used to communicate between members of the discourse

community (physician- physician, physician- nurse)?Patients?

a. Yes

b. No

7. How do genres and lexis help facilitate communication among you and the other

members of your discourse community? If not, how do they hinder communication?

Answer in the text box.

8. How important is communication within the medical setting?

a. Highly important

b. Important

c. Moderately important

d. Not important at all

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Appendix C

Survey Results

1.

2.

3.
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4.

5.

6.

8.
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Appendix D

Consent Form:
I, Jorge Quintero, am consenting to participate in an interview about medical discourse
communities, specifically about the community in which I am a member.

Which is being conducted by Angie Quintero for ENC 1102 at the University of Central Florida
with Professor Sara Thames.

My participation is voluntary, and I understand that I can discontinue the study at any time. I
understand that I am also free to withdraw from the study after the interview has been completed
without penalty.

I understand that I will not be paid for my participation.

I understand that this study may pose the following risks to me: Mild Discomfort

I understand that I may decline to answer questions that make me uncomfortable.

The researcher anticipates that this research will take about half an hour of your time.

If I do not wish for the researcher to record or keep/use my answers, I understand that I will not
be able to participate in the study.

I understand that I have the right to ask that the researcher does not identify me by name and that
I have the right to remain anonymous if I wish to remain so.

I understand that this study has not been reviewed by UCF’s IRB.

I am over 18 and I have read and understand the statements above and consent to participate in
the study.

Jorge Armando Quintero (signature)

February 26, 2021 (date)

Angie Quintero (principal researcher)

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Appendix E
CITI Training Certificate: