Directness of advice giving in traditional Chinese medicine consultations

Many studies of doctor–patient interaction have identified ways healthcare practitioners use various discourse strategies to mitigate the directness of their advice in medical consultations; however, precisely how healthcare practitioners express directness has been overlooked. Traditional Chinese medicine (TCM), one of the most popular therapeutic approaches to medicine, is of increasing importance in medical discourse research despite a relative lack of studies. To contribute to an understanding of modern Chinese medicine practice and doctor–patient communication in the TCM context, this study identifies categories of direct advice occurring in TCM consultations and explores how the directness of Chinese medical practitioners' advice is discursively constructed, negotiated, and perceived by consultation participants. Findings show that Chinese medical practitioners frequently use direct advice to express directness. Direct advice is often phrased in the imperative without mitigations. Occasionally, patients participate in the construction of directness by specifying practitioners' direct advice. Directness is also sometimes mitigated in direct advice via practitioners' medical explanations. Drawing upon the framework of relational work (Watts, 2003), this study argues that participants view advice directness in TCM consultations as judicious and appropriate. Chinese medical practitioners’ directness when offering advice in consultations can be attributed to the medical theory of TCM. Copyright © 2020 Elsevier B.V. All rights reserved.