Family doctors are far more likely to use “we” than patients, who are far more likely to use “I” during consultations, researchers have shown, in what is believed to be the first in depth study of pronoun use by doctors and patients.
A team from the Department of General Practice at Birmingham University analysed audiotapes of 375 consultations at 21 practices in the West Midlands for use of first person pronouns .
They found that the average number of words spoken at each consultation was 1742. Doctors used an average of 933 words and patients used an average of 794.
Doctors were far more likely than patients or their companions to use the word “we” and far less likely to use the word “I.” Doctors selected “we” on 24% of occasions when they used a first person pronoun. Patients and their companions selected “we” on 2.9% of occasions.
The research points out the importance of communication. It says that while advice to doctors on how to communicate with patients has centred on issues such as providing appropriate settings and avoiding jargon, other factors are involved too.
“One such area is the use of the pronouns—I, we, me, and us. Little work has been done on this apparently small area,” say the authors.
Choice of the word “we” is important because of its different uses, they say. There is the inclusive we, meaning “you and I,” and an exclusive we, meaning “we doctors and not you patients.” Doctors' use of “we” might also be evidence of partnership in the consultation and imply a collaborative approach to solving the problem together.
The authors say that on many occasions when “we” is used an inclusive interpretation is plausible. “However, the fundamental ambiguity of the doctor's use of ‘we’ may undermine this as a conclusion—that is, the doctor may or may not aim to be inclusive and may or may not be perceived as doing so by the patient,” they say.
“The overall picture is of considerable differences in the selection of ‘I’ and ‘we.’ The fact that patients and companions never included the doctor when they said ‘we’ is particularly interesting and—from the point of view of patient partnership—disappointing.”
The authors point out that the use of the pronoun shows “a systematic ambiguity at the heart of the consultation, which at worst may permit doctors to feel they are inclusive when in fact they are not.” They conclude that there is one obvious solution: doctors should use “you and I” rather than “we.”