Hedging in Medical Consultations: A Corpus-Based Analysis of Physician–Patient Communication in UK Primary and Specialist Care Settings

Abstract

This study examines the frequency, distribution, and pragmatic functions of hedging devices in medical doctor–patient consultations, focusing on how linguistic mitigation strategies operate within institutional healthcare discourse. A corpus of 400 recorded and transcribed consultations drawn from UK primary care and specialist medical settings is analyzed to identify patterns of hedge usage and their communicative functions. The analysis is grounded in Hyland’s (1998) taxonomy of hedging, Brown and Levinson’s (1987) politeness theory, and sociolinguistic approaches to medical interaction (Mishler, 1984), enabling a multi-layered interpretation of linguistic mitigation in clinical encounters. The study specifically investigates how hedges function to express epistemic uncertainty, manage interpersonal relations, and regulate the asymmetry of knowledge between physicians and patients. Findings indicate that physicians employ hedging strategies more frequently in contexts involving diagnostic uncertainty, delivery of adverse medical information, and prognostic evaluation, suggesting a strong association between hedging and face-sensitive communicative acts. Specialist consultations exhibit a higher overall density of hedging compared to primary care interactions, reflecting increased diagnostic complexity and epistemic caution in specialized medical domains. In contrast, patient-produced hedges are concentrated in symptom descriptions and question formulations, where they function primarily as epistemic mitigation of lay knowledge claims and uncertainty regarding medical terminology and interpretation. The results highlight hedging as a central discursive resource for negotiating authority, uncertainty, and interpersonal sensitivity in clinical communication. The study contributes to research in medical discourse analysis, pragmatics, and healthcare communication, with practical implications for physician training, patient-centered care models, and the improvement of communicative effectiveness in clinical practice.