Power and Ideology in Doctor-Patient Discourse: A Critical Analysis of Interactions at Woldia Hospital, North Eastern Ethiopia

This study critically analyzes the discourse of doctor-patient interaction at Woldia Hospital, Northern Ethiopian context. Using a qualitative research design and purposive sampling, data was collected from seven doctors and their patients through audio-recordings, observation, and semi-structured interviews. The analysis, guided by a theoretical framework that integrates Critical Discourse Analysis (CDA), Conversation Analysis (CA), and Speech Act Theory, follows Fairclough’s three-dimensional model to investigate the linguistic manifestations of power and ideology. The findings reveal a pronounced power asymmetry within the institutional discourse. Doctors exercise significant control over the interaction through exclusive rights to turn-taking and topic control, primarily achieved through the frequent use of interrogative sentences. This power dynamic is further manifested through their use of bald-on-record directive speech acts and technical jargon, which threatens the patient’s negative face and reinforces a knowledge gap. In contrast, patients predominantly adopt a submissive, reactive role, employing negative politeness strategies to mitigate threats to the doctor’s authority. The study concludes that language use in medical encounters is not merely a descriptive tool but a powerful social practice that both reflects and actively reproduces existing social relations and ideological assumptions, such as the doctor’s inherent expertise and authority. These findings provide critical insights into the nature of medical communication in the region and underscore the urgent need for communication skills training for healthcare professionals to foster a more egalitarian and effective doctor-patient relationship.