Patient-centred communication in British, Italian and Spanish ‘Ask-the-Expert’ healthcare websites

Existing studies on the online asynchronous consultation mode afforded by ‘Ask-the-Expert’ health websites (e.g. Thomson et al. 2012) are concerned with the possible loss in the quality of interaction between patients and clinicians in this type of consultation. The potential loss is worrying, given the central role of patient-centred communication (PCC), particularly empathy, in medical consultation practice and patients’ increasing use of and reliance on online consultations. This study addresses the following three related questions: (1) To what extent is PCC represented in ‘Ask-the-Expert’ healthcare websites? (2) Are there noticeable differences in PCC between sites operating in different linguistic and cultural settings (the UK, Spain and Italy)? (3) What are the implications of the above? Seventy exchanges from the leading independent health websites NetDoctor (UK), Netdoctor (Spain) and Medicitalia (Italy) were analysed, adapting a framework developed for the linguistic analysis of clinical empathy (combining discourse analytical and pragmatic categories – Pounds 2011) and drawing on existing definitions of PCC and classifications of advice-giving structures. The analysis shows that PCC is used on these sites to varying degrees, conforming to the site’s affordances. The significance of the findings and potential further applications of the analytical framework are discussed in the final part.