A pragmalinguistic analysis of missed opportunities for building rapport in interpreted medical interviews with Spanish-speaking patients.

Interpreted medical discourse presents significant challenges for communication because portions of the original message are often reduced, omitted, or revised (Aranguri, Davidson, & Ramirez, 2006), particularly by lay interpreters. Linguistic devices that contribute to rapport and politeness, such as mitigation, are often perceived as unimportant or unnecessary and are therefore omitted. Thus, when messages are conveyed without interpretation of politeness and rapport attempts, pragmatic issues and misunderstandings occur. The present investigation analyzed 43 transcriptions of interpreted medical consultations previously recorded at a family medicine clinic in Central Texas. The analysis quantified which rapport-building attempts most frequently occurred but were not interpreted and examined specific and general effects of noninterpretation, as well as potential consequences for physician-patient communication and rapport.