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Discourse Methods and Critical Practice in Professional Communication

The Front-Stage and Back-Stage Discourse of Prognosis in Medicine

Wayne State University

A set of discourse-based methods—genre theory, genre analysis, and discourse analysis—can provide a descriptive basis for a critical analysis of the multiple connections between discourse practices and their underlying concepts and categories within professions. To illustrate this theoretical and methodological project, this article analyzes prognosis in the discourse of medicine. Using Goffman’s (1959) distinction between front-stage and back-stage discourse, the author suggests that a back-stage discourse of prognosis points to problems with prognosis in the front-stage discourse of medical encounters between oncologists and patients who have been diagnosed with cancer. The analysis shows that the oral genre of treatment discussion in oncology encounters is organized to allow practitioners to do, appear to do, or avoid doing difficult work like presenting a prognosis. The article suggests that discourse-based methods have the potential to become the basis for productive critical engagement between practitioners and researchers in professional communication.

Key Words: discourse analysis • genre analysis • genre theory • professional communication • discourse of medicine • medical communication • treatment discussions • prognosis • medical oncology

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