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Patient-centred communication in British, Italian and Spanish ‘Ask-the-Expert’
healthcare websites.

Existing studies on the online asynchronous consultation
mode afforded by ‘Ask-the-Expert’ health websites
(e.g. Thomson et al. 2012) are concerned with
the possible loss in the quality of interaction between
patients and clinicians in this type of consultation.
The potential loss is worrying, given the central role
of patient-centred communication (PCC), particularly
empathy, in medical consultation practice and
patients’ increasing use of and reliance on online
consultations. This study addresses the following
three related questions: (1) To what extent is PCC
represented in ‘Ask-the-Expert’ healthcare websites?
(2) Are there noticeable differences in PCC between
sites operating in different linguistic and cultural
settings (the UK, Spain and Italy)? (3) What are the
implications of the above? Seventy exchanges from
the leading independent health websites NetDoctor
(UK), Netdoctor (Spain) and Medicitalia (Italy)
were analysed, adapting a framework developed for
the linguistic analysis of clinical empathy (combining
discourse analytical and pragmatic categories –
Pounds 2011) and drawing on existing definitions of
PCC and classifications of advice-giving structures.
The analysis shows that PCC is used on these sites to
varying degrees, conforming to the site’s affordances.
The significance of the findings and potential further
applications of the analytical framework are discussed
in the final part.