Abstract
Background: A great deal has been written about the English language medical interview in the western world, but almost nothing is known about the nature of doctor-patient consultations in other cultural contexts. This study is concerned with a description of consultations conducted in English in Abu Dhabi, UAE, specifically with the extent to which such consultations are doctor-centred. Methods: Interviews were conducted in the hospitals of Abu Dhabi. 67 interviews were collected which made substantial use of English: of these, 32 were selected in which there was little or no code-switching. Patients were: 11 Indian, 1 Sri Lankan, 1 Somali, 1 Tunisian, 3 Egyptian, 3 Filipino, 1 Sudanese, 6 Pakistani, 1 Lebanese, 1 Tanzanian, 1 Palestinian, 1 British and 1 Syrian; the doctors (M = 7, F = 1) were: 2 Egyptian, 4 Indian, 1 Iraqi and 1 Palestinian. The interviews were analysed using a mix of qualitative and quantitative analysis, drawn from validated (though often contradictory) traditions of research centred on previous approaches to the notion of doctor-centredness. The qualitative study is broadly ethnographic in orientation, the quantitative work measures such functional elements as: question-type and frequency, initiations, signals of support, greetings and farewells, conversational interaction, social and clinical history of presenting problem, and management plan. Results: The principal finding was that the doctors in this study employ a doctor-centred consultation style. They tend to ask closed questions; they seldom ask about social and psychological history, or check understanding; they seldom negotiate management plans. Patients ask few questions and speak relatively little. Interviews are short compared to western norms, greetings and farewells are brief and there is little social interaction. Conclusion: Models of the medical interview which are current in the literature are misleading if applied to this cultural context. If more holistic medical training is conducted in UAE in line with current thinking in medical schools in UK and North America (or, generally, in non-western contexts), these findings will have considerable implications for medical training and education.