Communication and Persuasion: The Rhetoric of Medicine

For the past two years I worked as a Medical Assistant for a Neurological Center. I’m also an EMT and am planning on going to PA school to work in the Emergency Room. When the topic of this blogpost was first introduced I thought it would be difficult to find use of rhetoric in the Doctor’s office because, after all, it is a very scientific field with lots of facts and evidence at your fingertips. I was surprised to find that, as I have observed my surroundings, I noticed that there are many uses of rhetoric in my clinic alone. The following are avenues of rhetoric that I have become alive to me.

Believe it or not all patients want to do what they’re instructed. A doctor can’t force a patient to proceed with recommended treatment, but they can persuade a patient to pursue a prescribed procedure.  Most physicians come with a certain type of ethos already intact. After all, the patient has already been persuaded to seek the doctor’s help. That ethos can be strengthened throughout the appointment if the doctor is attentive, instructive, and whose therapy sounds conducive to good health.

In a Doctor’s office, the Doctor isn’t the only one who uses rhetoric.  In many cases it is difficult to see who is trying to persuade who. A patient needs to be an advocate for their own health, and though a Doctor has had much schooling, they are human and prone to mistake. A patient’s persuasive power comes from the fact that they know what they’re feeling. They act as their own personal witness to their testimony because no one can tell them what they are feeling. A wise doctor always listens to what his patients are saying.

If you put 5 doctors in a room and you end up with 10 different diagnoses. While this is an exaggeration it does illustrate that not all doctors agree with one another’s diagnosis on a patient’s illness. Doctors are regularly persuading other doctors to try new treatments and diagnose difficult patients. When this happens the logos in the room becomes very thick. Testimonies, references, and ethos all play major factors in persuading other doctors.

Ever wonder how a doctor knows which drugs to prescribe you? Believe it or not, a doctor doesn’t have an unlimited knowledge of which drugs are on the market or the effectiveness of every pill. Pharmaceutical companies (drug companies) test and manufacture drugs and send representatives (called drug reps) to persuade physicians and physician assistants to use said drugs. This typically consists of a well-dressed salesman attempting to build ethos by showing other doctors or practices that use the drug, power point slides of studies used to show efficacy of drug. Something that has always impressed me is the way these drug reps use medical lingo. Though they haven’t gone through medical school they have been trained to speak using medical terms because they have found this is more persuasive to physicians.

Doctors come in many shapes and sizes, with many different philosophies and motivations. While all may differ in approach, it can be said that no doctor has come to be a doctor without putting in countless hours of study and practice. Because medical school is so “intensive” and “extensive”, a doctor values knowledge, facts, and experimental results. These tools are found useful in persuading doctors.

In the field of medicine, few care about the past because there is nothing that can be done to change it. Because the present is all we have to work with and the future is all we have to hope for, the primary form of persuasion is deliberative, yet many handle their approach differently.

Some doctors I have met have what I call “The God complex”. As a result of their degree and the fact that people are coming to them daily to ask for help and advice they come to feel that they are the ultimate authority. While this “my way or the highway” approach of persuasion works very well on getting patients to continue with a set form of therapy, it lacks the persuasive power that some physician’s possess who can explain the benefits of the treatment. Just because people know that something is good or bad for them doesn’t mean they’ll follow the treatment. In my clinic we treat many people with addictions, the doctors constantly inform the patient of the perils this path presents, but few follow the physician’s forewarning. Sometimes it is not enough to present the facts, a patient must be persuaded by what is important to them.