The tenor of consultant physicians: implications for medical interpreting

Medical interpreting, like many other kinds of community interpreting, needs to have conveyed not only the content of what speakers say but the way they say it. This paper outlines a model, derivedfrom empirical research, of the discourse structure of the interpreted medical consultation. The generic structure of interpreted physicians' consultations with non-English speaking patients shows eleven stages, the climax being the exposition. It is at this stage that the physician announces hislher findings of the diagnoses and sets up a plan of action for the patient. The extent to which the patient complies with the plan of action (e.g. change of medication) does not depend just on the fact that an interpreter interpreted the consultation, but substantially on the rapport and impact that the physician had on the patient. So conveying accurately the interpersonal elements of what the physician and patient say to each other is crucial. A theoretical frameworkfor analyzing the interpersonal metafunction is described and components of this framework are applied to two case studies of the exposition, one in nephrology and the other in hypertension. Enhancing medical interpreters' understanding of how to 'read' the tenor of a physician 's consulting style needs a theoretical basis. This paper offers a contribution to the development o.fsuch a theory.