Brad Davidson | School of Visual Arts, New York (original) (raw)
Papers by Brad Davidson
Journal of General Internal Medicine, Jun 1, 2006
BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less sati... more BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less satisfactory communication with physicians; few have studied how actual communication takes place through an interpreter in a clinical setting. OBJECTIVE: Record and analyze physician-interpreter-patient interactions. DESIGN: Primary care physicians with high-volume Hispanic practices were recruited for a communication study. Dyslipidemic Hispanic patients, either monolingual Spanish or bilingual Spanish-English, were recruited on the day of a normally scheduled appointment and, once consented, recorded without a researcher present in the room. Separate postvisit interviews were conducted with the patient and the physician. All interactions were fully transcribed and analyzed. PARTICIPANTS: Sixteen patients were recorded interacting with 9 physicians. Thirteen patients used an interpreter with 8 physicians, and 3 patients spoke Spanish with the 1 bilingual physician. APPROACH: Transcript analysis based on sociolinguistic and discourse analytic techniques, including but not limited to time speaking, analysis of questions asked and answered, and the loss of semantic information. RESULTS: Speech was significantly reduced and revised by the interpreter, resulting in an alteration of linguistic features such as content, meaning, reinforcement/validation, repetition, and affect. In addition, visits that included an interpreter had virtually no rapport-building ''small talk,'' which typically enables the physician to gain comprehensive patient history, learn clinically relevant information, and increase emotional engagement in treatment. CONCLUSIONS: The presence of an interpreter increases the difficulty of achieving good physician-patient communication. Physicians and interpreters should be trained in the process of communication and interpretation, to minimize conversational loss and maximize the information and relational exchange with interpreted patients.
Journal of Clinical Oncology, 2006
6141 Background: Adjuvant hormonal therapy in breast cancer presents a conversational challenge f... more 6141 Background: Adjuvant hormonal therapy in breast cancer presents a conversational challenge for oncologists. Oral medications are a relatively new therapeutic paradigm, and many aspects of typical oncology communication, e.g., risk-benefit presentation, goal of therapy, and the role of patient in selecting/continuing therapy, require a different approach in this setting. An observational linguistic study was undertaken to capture how oncologists and patients discuss adjuvant therapy, and to develop recommendations to improve communication. Methods: Letters of invitation were mailed to 800+ community-based oncologists; of these, 14 met the screening criteria and agreed to participate in this study. 28 postmenopausal, early breast cancer patients on or initiating hormonal therapy were recorded during their regularly scheduled visits. Results: Adjuvant hormonal therapy discussions differ from infusional chemotherapy-focused oncology discussions in several ways: Selection of therapy...
From the beginning, the Internet has allowed patients and caregivers to create online communities... more From the beginning, the Internet has allowed patients and caregivers to create online communities that provide something offline communities cannot. In the case of rare genetic disorders, it is a chance to connect with others who know what you are facing; in the case of debilitating disease, a chance to talk openly with others who know what it is like to live in an able-bodied society. The same way that deaf communities sprung up throughout the world, online communities lack formal institutional structures, and come in a number of shapes and sizes, with different cultural norms, interactional rules, and languages. Anthropology and linguistics, as sciences focusing on society and communication, are ideally suited to unpack and understand these communities. We explore real-world examples of online health-related communities, the belief structures of groups, the fault-lines that exist, and what these analyses tell us about the real-world needs and experiences of community members.
Journal of Clinical Oncology, 2005
ABSTRACT Background: Many instruments exist for determining the impact of chemotherapy-induced an... more ABSTRACT Background: Many instruments exist for determining the impact of chemotherapy-induced anemia and related fatigue on patient quality-of-life, but there are few studies that analyze how health care providers actually discuss anemia and fatigue with patients.
Journal of Clinical Oncology, 2012
229 Background: Discussions of therapeutic risk or benefit have a different tone in patients faci... more 229 Background: Discussions of therapeutic risk or benefit have a different tone in patients facing metastatic cancer. The literature predicts misalignment on therapy selection and communication gaps between patients and physicians. Gaps in assumed reasons for therapy selection may hinder the mCRPC patient’s ability to make fully informed decisions. (Fine, E. et al; J. Palliative Med, 2010, 13(5); 595-603.) Methods: This IRB-approved, observational, linguistic study describes naturally occurring conversations between mCRPC patients (n=42; 69% African American) and their treating urologist (n=7) or oncologist (n=7) during a normal clinic visit in Summer 2011. Clinic interactions were videotaped without 3rd party observers present. Patients and physicians were interviewed again separately after the clinic visit. All conversations were transcribed and analyzed using standard techniques from anthropology and discourse analysis fields. Results: At both a lexical and goal-oriented level, ...
Many clinicians feel that long-acting injectable therapy (LAT) is an underused option, and that p... more Many clinicians feel that long-acting injectable therapy (LAT) is an underused option, and that patient rejection of LAT is a major barrier to its routine use. To test this hypothesis, we conducted an observational study of LAT recommendations in routine community settings. A linguistic analysis of videotapes and transcriptions of interactions revealed that physicians seemed more reluctant than patients with the LAT recommendation. Physicians' descriptions of daily practices bore only partial resemblance to observed practices with respect to their descriptions of the selection criteria for patients to whom LAT therapy will be proposed, the nature of that recommendation, and the nature of the patients' initial acceptance or rejection of that therapy. Overall findings include: • Physicians' identification of a patient as nonadherent is insufficient to predict an LAT offer • Physicians' recommendations for LAT often do not include descriptions of possible specific benef...
Annual Meeting of the Berkeley Linguistics Society, 1997
Proceedings of the Twenty-Third Annual Meeting of the Berkeley Linguistics Society: General Sessi... more Proceedings of the Twenty-Third Annual Meeting of the Berkeley Linguistics Society: General Session and Parasession on Pragmatics and Grammatical Structure (1997)
The journal of supportive oncology, 2007
Although studies have proven the benefit of 5+ years of adjuvant hormonal therapy (AHT) for breas... more Although studies have proven the benefit of 5+ years of adjuvant hormonal therapy (AHT) for breast cancer, data show adherence and persistence with therapy are suboptimal. This observational linguistic study analyzed communication between breast cancer patients and their oncologists to determine how adherence was addressed and to identify areas where communication could be improved. Community-based oncologists were recruited by letter to participate. Researchers visited oncologists (n = 14) to record patient-oncologist interactions and conduct separate post-visit interviews. Comprehensive linguistic analyses of visits between 28 postmenopausal, early-stage breast cancer patients on or initiating hormonal therapy and their oncologists were conducted to determine the nature of discussions of adherence and persistence to therapy. Oncologist-patient discussions about AHT were generally good but did not address potential difficulties of remaining adherent with long-term therapy. Discussi...
The Journal of Urology, 2012
The Journal of clinical psychiatry, 2015
To characterize patterns of communication in the offer of long-acting injectable (LAI) antipsycho... more To characterize patterns of communication in the offer of long-acting injectable (LAI) antipsychotic medication made by psychiatrists to patients with schizophrenia by (1) examining the style and content of their interaction and (2) determining how these may have driven the ultimate response to recommendations for LAI therapy. This was an observational study conducted at 10 community mental health centers in 3 waves from July 2010 to May 2011. The final dataset for discourse analysis was 33 recorded conversations in which a psychiatrist offered an injectable antipsychotic to a patient with schizophrenia. These visits were transcribed and analyzed by a team of linguists and social scientists. Our primary finding is that, based on analyses of their language during the interview, psychiatrists presented LAI therapy in a negative light. Supporting this, 11 of 33 recommendations (33%) were accepted during the discussion, whereas in the postvisit interview, 27 of 28 patients (96%) who see...
J Support …, 2007
Many validated instruments exist for determining the impact of chemotherapy-induced anemia and re... more Many validated instruments exist for determining the impact of chemotherapy-induced anemia and related fatigue on patient quality of life, but few studies analyze how healthcare providers actually discuss these subjects with patients. The authors share their ...
Journal of pragmatics, 1996
Spanish is a pro-drop language in which first and second person subject pronouns are frequently o... more Spanish is a pro-drop language in which first and second person subject pronouns are frequently omitted (80%); traditionally the function of overt subject pronouns has been regarded as adding emphasis or to contrast explicit statements. I argue that their function ...
Journal of pragmatics, 2002
This article examines the role of the interpreters in cross-linguistic discourse, arguing that ea... more This article examines the role of the interpreters in cross-linguistic discourse, arguing that earlier analyses of their functions as 'voiceboxes' or mere instruments of linguistic conversion do not adequately describe the processes by which linguistic common ground is constructed between speakers of different languages (Clark, Herbert H., 1992. Arenas of Language Use. University of Chicago Press, Chicago. Clark, Herbert H., 1996. Using Language Cambridge Uniiversity Press, Cambridge). Central to this analysis is the notion that the interpreter must be engaged in the (re)construction of contextually relevant meaning (Wadensjo¨, Cecilia, 1998. Interpreting as Interaction. Longman, London and New York). These findings are demonstrated through the development of a model that accounts for all possible turn-types within interpreted discourse, and the application of this model to several stretches of naturally occurring interpreted medical discourse.
Anthropological Quarterly, 2001
... outset that the interpretation of medical discourse, Spanish-English medical interpreters at ... more ... outset that the interpretation of medical discourse, Spanish-English medical interpreters at a public hosindeed. ... on Bilingualism. Kaufert, JM, and Koolage WW 1984. Role conflict among ''culture brokers'': The experience of native Canadian medical interpreters. ...
Journal of Sociolinguistics, 2000
Increases in immigration have led to an enormous growth in the number of cross-linguistic medical... more Increases in immigration have led to an enormous growth in the number of cross-linguistic medical encounters taking place throughout the United States. In this article the role of hospital-based interpreters in cross-linguistic, internal medicine `medical interviews' is examined. The ...
Journal of general internal …, 2006
Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Satu... more Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Saturday, 2 October - New York 0500 EDT to 0700 EDT; London 1000 BST to 1200 BST; Singapore 1700 SGT to 1900 SGT. ... *Correspondence: Address correspondence ...
Journal of General Internal Medicine, Jun 1, 2006
BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less sati... more BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less satisfactory communication with physicians; few have studied how actual communication takes place through an interpreter in a clinical setting. OBJECTIVE: Record and analyze physician-interpreter-patient interactions. DESIGN: Primary care physicians with high-volume Hispanic practices were recruited for a communication study. Dyslipidemic Hispanic patients, either monolingual Spanish or bilingual Spanish-English, were recruited on the day of a normally scheduled appointment and, once consented, recorded without a researcher present in the room. Separate postvisit interviews were conducted with the patient and the physician. All interactions were fully transcribed and analyzed. PARTICIPANTS: Sixteen patients were recorded interacting with 9 physicians. Thirteen patients used an interpreter with 8 physicians, and 3 patients spoke Spanish with the 1 bilingual physician. APPROACH: Transcript analysis based on sociolinguistic and discourse analytic techniques, including but not limited to time speaking, analysis of questions asked and answered, and the loss of semantic information. RESULTS: Speech was significantly reduced and revised by the interpreter, resulting in an alteration of linguistic features such as content, meaning, reinforcement/validation, repetition, and affect. In addition, visits that included an interpreter had virtually no rapport-building ''small talk,'' which typically enables the physician to gain comprehensive patient history, learn clinically relevant information, and increase emotional engagement in treatment. CONCLUSIONS: The presence of an interpreter increases the difficulty of achieving good physician-patient communication. Physicians and interpreters should be trained in the process of communication and interpretation, to minimize conversational loss and maximize the information and relational exchange with interpreted patients.
Journal of Clinical Oncology, 2006
6141 Background: Adjuvant hormonal therapy in breast cancer presents a conversational challenge f... more 6141 Background: Adjuvant hormonal therapy in breast cancer presents a conversational challenge for oncologists. Oral medications are a relatively new therapeutic paradigm, and many aspects of typical oncology communication, e.g., risk-benefit presentation, goal of therapy, and the role of patient in selecting/continuing therapy, require a different approach in this setting. An observational linguistic study was undertaken to capture how oncologists and patients discuss adjuvant therapy, and to develop recommendations to improve communication. Methods: Letters of invitation were mailed to 800+ community-based oncologists; of these, 14 met the screening criteria and agreed to participate in this study. 28 postmenopausal, early breast cancer patients on or initiating hormonal therapy were recorded during their regularly scheduled visits. Results: Adjuvant hormonal therapy discussions differ from infusional chemotherapy-focused oncology discussions in several ways: Selection of therapy...
From the beginning, the Internet has allowed patients and caregivers to create online communities... more From the beginning, the Internet has allowed patients and caregivers to create online communities that provide something offline communities cannot. In the case of rare genetic disorders, it is a chance to connect with others who know what you are facing; in the case of debilitating disease, a chance to talk openly with others who know what it is like to live in an able-bodied society. The same way that deaf communities sprung up throughout the world, online communities lack formal institutional structures, and come in a number of shapes and sizes, with different cultural norms, interactional rules, and languages. Anthropology and linguistics, as sciences focusing on society and communication, are ideally suited to unpack and understand these communities. We explore real-world examples of online health-related communities, the belief structures of groups, the fault-lines that exist, and what these analyses tell us about the real-world needs and experiences of community members.
Journal of Clinical Oncology, 2005
ABSTRACT Background: Many instruments exist for determining the impact of chemotherapy-induced an... more ABSTRACT Background: Many instruments exist for determining the impact of chemotherapy-induced anemia and related fatigue on patient quality-of-life, but there are few studies that analyze how health care providers actually discuss anemia and fatigue with patients.
Journal of Clinical Oncology, 2012
229 Background: Discussions of therapeutic risk or benefit have a different tone in patients faci... more 229 Background: Discussions of therapeutic risk or benefit have a different tone in patients facing metastatic cancer. The literature predicts misalignment on therapy selection and communication gaps between patients and physicians. Gaps in assumed reasons for therapy selection may hinder the mCRPC patient’s ability to make fully informed decisions. (Fine, E. et al; J. Palliative Med, 2010, 13(5); 595-603.) Methods: This IRB-approved, observational, linguistic study describes naturally occurring conversations between mCRPC patients (n=42; 69% African American) and their treating urologist (n=7) or oncologist (n=7) during a normal clinic visit in Summer 2011. Clinic interactions were videotaped without 3rd party observers present. Patients and physicians were interviewed again separately after the clinic visit. All conversations were transcribed and analyzed using standard techniques from anthropology and discourse analysis fields. Results: At both a lexical and goal-oriented level, ...
Many clinicians feel that long-acting injectable therapy (LAT) is an underused option, and that p... more Many clinicians feel that long-acting injectable therapy (LAT) is an underused option, and that patient rejection of LAT is a major barrier to its routine use. To test this hypothesis, we conducted an observational study of LAT recommendations in routine community settings. A linguistic analysis of videotapes and transcriptions of interactions revealed that physicians seemed more reluctant than patients with the LAT recommendation. Physicians' descriptions of daily practices bore only partial resemblance to observed practices with respect to their descriptions of the selection criteria for patients to whom LAT therapy will be proposed, the nature of that recommendation, and the nature of the patients' initial acceptance or rejection of that therapy. Overall findings include: • Physicians' identification of a patient as nonadherent is insufficient to predict an LAT offer • Physicians' recommendations for LAT often do not include descriptions of possible specific benef...
Annual Meeting of the Berkeley Linguistics Society, 1997
Proceedings of the Twenty-Third Annual Meeting of the Berkeley Linguistics Society: General Sessi... more Proceedings of the Twenty-Third Annual Meeting of the Berkeley Linguistics Society: General Session and Parasession on Pragmatics and Grammatical Structure (1997)
The journal of supportive oncology, 2007
Although studies have proven the benefit of 5+ years of adjuvant hormonal therapy (AHT) for breas... more Although studies have proven the benefit of 5+ years of adjuvant hormonal therapy (AHT) for breast cancer, data show adherence and persistence with therapy are suboptimal. This observational linguistic study analyzed communication between breast cancer patients and their oncologists to determine how adherence was addressed and to identify areas where communication could be improved. Community-based oncologists were recruited by letter to participate. Researchers visited oncologists (n = 14) to record patient-oncologist interactions and conduct separate post-visit interviews. Comprehensive linguistic analyses of visits between 28 postmenopausal, early-stage breast cancer patients on or initiating hormonal therapy and their oncologists were conducted to determine the nature of discussions of adherence and persistence to therapy. Oncologist-patient discussions about AHT were generally good but did not address potential difficulties of remaining adherent with long-term therapy. Discussi...
The Journal of Urology, 2012
The Journal of clinical psychiatry, 2015
To characterize patterns of communication in the offer of long-acting injectable (LAI) antipsycho... more To characterize patterns of communication in the offer of long-acting injectable (LAI) antipsychotic medication made by psychiatrists to patients with schizophrenia by (1) examining the style and content of their interaction and (2) determining how these may have driven the ultimate response to recommendations for LAI therapy. This was an observational study conducted at 10 community mental health centers in 3 waves from July 2010 to May 2011. The final dataset for discourse analysis was 33 recorded conversations in which a psychiatrist offered an injectable antipsychotic to a patient with schizophrenia. These visits were transcribed and analyzed by a team of linguists and social scientists. Our primary finding is that, based on analyses of their language during the interview, psychiatrists presented LAI therapy in a negative light. Supporting this, 11 of 33 recommendations (33%) were accepted during the discussion, whereas in the postvisit interview, 27 of 28 patients (96%) who see...
J Support …, 2007
Many validated instruments exist for determining the impact of chemotherapy-induced anemia and re... more Many validated instruments exist for determining the impact of chemotherapy-induced anemia and related fatigue on patient quality of life, but few studies analyze how healthcare providers actually discuss these subjects with patients. The authors share their ...
Journal of pragmatics, 1996
Spanish is a pro-drop language in which first and second person subject pronouns are frequently o... more Spanish is a pro-drop language in which first and second person subject pronouns are frequently omitted (80%); traditionally the function of overt subject pronouns has been regarded as adding emphasis or to contrast explicit statements. I argue that their function ...
Journal of pragmatics, 2002
This article examines the role of the interpreters in cross-linguistic discourse, arguing that ea... more This article examines the role of the interpreters in cross-linguistic discourse, arguing that earlier analyses of their functions as 'voiceboxes' or mere instruments of linguistic conversion do not adequately describe the processes by which linguistic common ground is constructed between speakers of different languages (Clark, Herbert H., 1992. Arenas of Language Use. University of Chicago Press, Chicago. Clark, Herbert H., 1996. Using Language Cambridge Uniiversity Press, Cambridge). Central to this analysis is the notion that the interpreter must be engaged in the (re)construction of contextually relevant meaning (Wadensjo¨, Cecilia, 1998. Interpreting as Interaction. Longman, London and New York). These findings are demonstrated through the development of a model that accounts for all possible turn-types within interpreted discourse, and the application of this model to several stretches of naturally occurring interpreted medical discourse.
Anthropological Quarterly, 2001
... outset that the interpretation of medical discourse, Spanish-English medical interpreters at ... more ... outset that the interpretation of medical discourse, Spanish-English medical interpreters at a public hosindeed. ... on Bilingualism. Kaufert, JM, and Koolage WW 1984. Role conflict among ''culture brokers'': The experience of native Canadian medical interpreters. ...
Journal of Sociolinguistics, 2000
Increases in immigration have led to an enormous growth in the number of cross-linguistic medical... more Increases in immigration have led to an enormous growth in the number of cross-linguistic medical encounters taking place throughout the United States. In this article the role of hospital-based interpreters in cross-linguistic, internal medicine `medical interviews' is examined. The ...
Journal of general internal …, 2006
Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Satu... more Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Saturday, 2 October - New York 0500 EDT to 0700 EDT; London 1000 BST to 1200 BST; Singapore 1700 SGT to 1900 SGT. ... *Correspondence: Address correspondence ...