{"id":251,"date":"2017-09-04T18:57:38","date_gmt":"2017-09-04T18:57:38","guid":{"rendered":"http:\/\/medicalrhetoric.com\/symposium2017\/?page_id=251"},"modified":"2018-06-01T12:29:45","modified_gmt":"2018-06-01T12:29:45","slug":"susan-popham","status":"publish","type":"page","link":"https:\/\/medicalrhetoric.com\/symposium2017\/profiles\/susan-popham\/","title":{"rendered":"Susan Popham"},"content":{"rendered":"

\"SusanTitle: <\/strong>Assistant Professor<\/p>\n

University: <\/strong>Indiana University Southeast<\/p>\n

Email: <\/strong>pophams@ius.edu<\/p>\n

Twitter: <\/strong>spopham<\/p>\n

Website: <\/strong>https:\/\/www.ius.edu\/biographies\/index.php\/?bioID=680&r=%2Farts-and-letters%2Fprograms%2Fenglish%2Ffaculty%2Findex.php&rt=Back%20to%20Faculty<\/p>\n

Description of Work:<\/strong><\/h3>\n

After having taught and researched at the University of Memphis for 15 years, I was hired at Indiana University Southeast, where I teach introduction to technical communication, editing, and this coming semester a senior-level, special topics course on critical media studies (Texts and Technologies). I enjoy teaching, and try to get my students interested in <\/i>learning how improved communication processes might help to improve their lives and careers.\u00a0 While my teaching practices have often made their way into some published research, usually online pedagogy, my real research studies focus on medical\/healthcare rhetoric. I have studied the rhetoric and discourse of electronic health records in a juvenile mental health system, the document design of medical examination forms, the <\/i>rhetoric of online health forums, the rhetoric of medical letters, and the rhetoric of healthcare communications. Almost all of my \u201cmedical\u201d research explores how medicine and medical practices use communication processes to function as a business, that is to file billing claims and to communicate with health insurance companies. The health insurance aspects of medicine and health still fascinate me, and seem especially important in current society. Recently, I\u2019ve become interested in how science intersects with medicine, and I\u2019m planning a corpus linguistic analysis of scientific tenets in evidence-based medicine.<\/p>\n

Symposium Submission:<\/strong><\/h3>\n

Medicine as a Business: Contradictions and Negotiations in Medical-Business Genres<\/strong>
\n<\/span><\/p>\n

Much research in medical discourse focuses on the genres medical practitioners are likely to produce, including medical records, research articles, technical manuals, and case histories (Charon, 1986, 1992; Hunter, 1991; Kaufman, 1988). This chapter explores the ways that medical clinics operate as business practices through a close analysis of several business-related genres, health insurance claim forms, letters written to health insurers, patient bills, etc. The theoretical frame that grounds the analysis of the genres arises from activity system theory, which proposes that genres function as tools for the work of the activity system(s).\u00a0\u00a0\u00a0<\/span><\/p>\n

Segal\u2019s (1993) study of articles on the topic of headache also examines the institutionally-based research publication. She examined over 200 research articles on the topic of headache and found that they exhibited writing characteristics which closely aligned with Western philosophies of medicine; namely they were paternalistic, atomistic, and interventionist. While one can argue, of course, that such writing characteristics shape Western philosophical values, Segal also argues that these articles are influenced by and reflect these values. She states that Western cultures\u2019 philosophical values are highly tenacious in the ways in which they continue to shape medical discourse. Thus a single genre, e.g. research articles, may perform multiple rhetorical tasks–to present and establish the authors, to meet audience expectations for expert and accurate knowledge, to strengthen a socialized conversation, and to reflect cultural values.\u00a0<\/span><\/p>\n

In other medical discourse studies, other genres are examined more closely in relation to their local context. For example, Schryer (1993) looked at the way medical records were presented in a veterinary school. She concluded that these records (the Problem Oriented Veterinary Medical Record System) were a genre which not only reflected the values of some of the school\u2019s faculty, but which also influenced the literacy abilities of the students whose writing and speaking styles seemed to \u201cimplicate that record-keeping system\u201d (p. 228). Schryer argues that this genre has become so powerful as to influence the style of writing in journal articles written by the clinicians (p. 225). Additional studies by McCarthy (1991) and Berkenkotter & Ravotas (1996) in the field of psychiatry have also described the ways that recording systems like DSM-IV shape the resulting treatment which the client receives (Berkenkotter & Ravotas) and how the DSM-III \u201cshapes what [the doctor] knows about mental illness and how she communicates that knowledge [. . .] her diagnostic work\u201d (McCarthy, p. 359). These studies show not only how the context influences the genres, but also how the genres rhetorically re-influence the context, the mutual constructedness which Winsor (1999) called for and is so pertinent to an in-depth understanding of the force of genres.\u00a0<\/span><\/p>\n

In addition, some studies in the field of medical genres also break free from simple chronologic, \u201cone-way\u201d descriptions of genres and context. Munger (2000) has published a study of emergency medical technician run reports, a unique genre in terms of medical discourse. Munger recognizes that \u201csuch a medical form is likely to reflect not just one profession\u2019s \u2018norms, values, and ideology\u2019 (Berkenkotter and Huckin 1), but several\u201d and that these genres are likely to become manifestations of conflict (p. 330).\u00a0\u00a0<\/span><\/p>\n

In sum, then, many studies of medical genres show them to be rhetorical in nature, getting work done, reflecting values of the larger culture, and reciprocally shaping and changing larger cultural contexts. Schryer\u2019s (2005) more recent work in medical genres and rhetoric claims that medical genres \u201cfunction as mediating tools that simultaneously structure and constrain the possibilities for rhetorical action\u201d (271). And as Bawarshi (2000) stated, genres constitute the social situation, so if professions compete for dominance and power, then genres, as active participants in that situation, help to create that competition.\u00a0 Schryer\u2019s (1993) and Dautermann\u2019s (1993, 1997) studies have described the complex relationship between context and text, although their studies have focused more on internal influences than external influences. Too, Dias et al. (1999) have also described how \u201cdifferent communities within the larger collective seek to advance\u201d their own agendas through \u201cindividual genres which may serve as sites of ideological struggle\u201d (p. 117). While these studies move very closely to the kinds of arguments and descriptions I make about medical-business writing, they remain studies of multiple, internal forces so that contentions are frequently resolved by the loyalty of the smaller communities to the values and stated goals of their larger collective. This attention to internalized forces glosses over struggles that arise from competing, external communities, although Popham\u2019s (2005) study of medical-business patient forms (2005) examines and analyzes how genres, such as patient forms, cross disciplinary boundaries of medicine and business.\u00a0 Here, in this study, I build on all these previous studies by analyzing how contentions and tensions among multiple, complex communities are represented in, sometimes originate in, and are negotiated through genres.\u00a0\u00a0\u00a0<\/span><\/p>\n

This study (fully complete, with IRB approval) closely investigates the function of business\/billing genres within three medical clinics, exploring and showing how these genres arise from the activity systems in which they are based, serve several different, simultaneous, often competing objectives for multiple activity systems, seek to mediate several contradictions between the competing objectives, and yet are often the very origination of these tensions and contradictions. The study examines these genres within their rhetorical context\u2014the activity system in which the genres reside\u2014by interviewing some of authors, by observing people as they use and read the genres, and by close rhetorical and theoretical (i.e. activity system and genre theories) analysis of the genres themselves. This triangulated research allows for a full and contextualized view of both the genres and the sites in which the genres reside and function.\u00a0 This research is important because it not only shows both the benefits and disadvantages of activity system theory as a research framework, but also builds on existing understandings about genre theory.\u00a0 More importantly, this study shows how the discourses and genres surrounding and in the fields of medicine and healthcare impact patients, physicians, healthcare support staff, policies, and the society at large.\u00a0<\/span><\/p>\n

References<\/b>\u00a0<\/span><\/p>\n

Bawarshi, A. (2000). The genre function. College English, 62<\/i>, 335-360.\u00a0<\/span><\/p>\n

Berkenkotter, C., Huckin, T. N. and Ackerman, J. (1995). Conventions, conversations, and the writer. Genre knowledge in disciplinary communication: Cognition\/culture\/ power. Eds. C. Berkenkotter and T. N. Huckin. Hillsdale, NJ: Lawrence Erlbaum, 117-144.\u00a0<\/span><\/p>\n

Berkenkotter, C, and Ravotas, D.\u00a0 (1996). Genre as tool in the transmission of practice over time and across professional boundaries. Mind, Culture, and Activity 4, 4, 256-274.\u00a0<\/span><\/p>\n

Charon, R. (1986). To render the lives of patients.\u00a0 Literature and Medicine 5, 58-74.\u00a0<\/span><\/p>\n

Charon, R. (1992). To build a case: Medical histories as traditions in conflict.\u00a0 Literature and Medicine 11, 1, 115-132.\u00a0<\/span><\/p>\n

Dautermann, J. (1997).\u00a0 Writing at good hope: A study of negotiated composition in a community of nurses. Greenwich, CT: Ablex.\u00a0<\/span><\/p>\n

Dautermann, J. (1993). Negotiating meaning in a hospital discourse community.\u00a0 Writing in the workplace: New research perspectives.\u00a0 Ed. Rachel Spilka, Carbondale: Southern Illinois University Press, 98-110.\u00a0<\/span><\/p>\n

Dias, P. et al. (1999). Worlds apart: Acting and writing in academic and workplace contexts. Mahwah, NJ: Erlbaum.\u00a0<\/span><\/p>\n

Hunter, K. A. (1991). Doctor\u2019s stories: The narrative structure of medical knowledge. Princeton: Princeton University Press.\u00a0<\/span><\/p>\n

Kaufman, J. M. (1988).\u00a0 The rhetoric of medical writing: Case studies of physicians writing for journal publication. Dissertation. University of Minnesota.\u00a0 Ann Arbor: UMI, 1990.\u00a0 8909456.\u00a0<\/span><\/p>\n

McCarthy, L. P. (1991). A psychiatrist using DSM-III: The influence of a charter document in psychiatry.\u00a0 Textual dynamics of the professions: Historical and contemporary studies of writing in professional communities.\u00a0 Eds. C. Bazerman and J. Paradis.\u00a0 Madison: University of Wisconsin Press, 358-380.\u00a0<\/span><\/p>\n

Popham, S. (2005).\u00a0 Forms as boundary genres in medicine, science, and business.\u00a0 Journal of Business and Technical Communication 19, 3. July 2005, 279-303.\u00a0<\/span><\/p>\n

Segal, J. Z. (1993). Writing and medicine: Text and context.\u00a0 Writing in the workplace: New research perspectives.\u00a0 Ed. Rachel Spilka, Carbondale: Southern Illinois University Press, 84-97.\u00a0<\/span><\/p>\n

Schryer, C. F., Lingard, L. and Spafford, M. (2005). Regulated and regularized: Genres, improvisation, and identity formation in health-care professions. In C. Thralls and M. Zachry (Eds.), The cultural turn: Perspectives on communicative practices in workplaces and professions.\u00a0 Amityville, NY: Baywood.chryer, C. F. (1993). Records as genre.\u00a0 Written Communication 10, 2, 200-34.\u00a0<\/span><\/p>\n

Winsor, D. A. (1999). Genre and activity systems: The role of documentation in maintaining and changing engineering activity systems.\u00a0 Written Communication 16, 2, 200-224.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Title: Assistant Professor University: Indiana University Southeast Email: pophams@ius.edu Twitter: spopham Website: https:\/\/www.ius.edu\/biographies\/index.php\/?bioID=680&r=%2Farts-and-letters%2Fprograms%2Fenglish%2Ffaculty%2Findex.php&rt=Back%20to%20Faculty Description of Work: After having taught and researched at the University of Memphis for 15 years, I … Continue reading “Susan Popham”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":2,"menu_order":39,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-251","page","type-page","status-publish","hentry"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/pages\/251","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/comments?post=251"}],"version-history":[{"count":4,"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/pages\/251\/revisions"}],"predecessor-version":[{"id":856,"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/pages\/251\/revisions\/856"}],"up":[{"embeddable":true,"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/pages\/2"}],"wp:attachment":[{"href":"https:\/\/medicalrhetoric.com\/symposium2017\/wp-json\/wp\/v2\/media?parent=251"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}