Missed Opportunities to Build Rapport: A Pragmalinguistic Analysis of Interpreted Medical Conversations with Spanish-Speaking Patients.

Interpreted medical discourse presents significant challenges for communication because portions of the original message are often reduced, omitted, or revised, particularly by untrained interpreters. Linguistic devices that contribute to rapport and politeness may be perceived as unimportant or unnecessary and therefore are omitted. Thus, when messages are conveyed without interpretation of politeness and rapport attempts, pragmatic issues and misunderstandings occur. This investigation examined 43 transcriptions of interpreted medical consultations at a family medicine clinic. We quantified rapport-building attempts that frequently occurred, yet were not interpreted. We then examined specific and general effects of non-interpretation and noted potential consequences for physician-patient communication. Building on both linguistic and communication frameworks, results align with previous research suggesting that rapport-related variables including verbal immediacy are not secondary to "more important" information communicated by doctors; instead, patients' impressions of rapport may be even more important than the health-related information itself. The application of linguistic pragmatics in this analysis offers additional insights into the relationship between verbal communication and rapport.