| Summary: | © 2018 Elsevier B.V. Although doctor-patient communication is an important part of medical discourse, the question remains as to how the paradigm operates when communication shifts from face-to-face interactions to the digital environment. This study investigates how Taiwanese medical doctors explored situational affordances when engaging in online medical consultation (OMC). Based on satisfaction ratings provided by online inquirers, this study also examines the contributing factors for a favorable or unfavorable reception of a reply in OMC, adopting the conceptual frameworks of pragmeme theory, adaptability and elasticity of language use. It proposes a model for analyzing acts performed in the pragmeme of OMC, and reveals how high-performance cases were characterized by a set of discourse features (e.g. a fitted question-answer match, personalized information for a specific inquirer, appropriate stretching of speech act range and of language) different from those found in low-performance cases (e.g. a question-answer mismatch, general public health information not tailored for individuals, no or little stretching of speech act range and of language). Furthermore, the study reveals how strong adaptability is achieved by an overall tendency to explore situational affordances and overcome situational constraints while weak adaptability is characterized by a tendency that stresses constraints without appropriately utilizing affordances. One implication is that medical communication does not have to be categorical – elastic information could be more effective.
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