The personal troubles that patients bring to doctors often have roots in social issues
beyond medicine. While medical encounters involve "micro-level" interactions between
individuals, these interpersonal processes occur in a social context shaped by "macro-level"
structures in society. Examining prior theories pertinent to medical discourse leads
to the propositions: (a) that medical encounters tend to convey ideologic messages
supportive of the current social order; (b) that these encounters have repercussions
for social control; and (c) that medical language generally excludes a critical appraisal
of the social context. The technical structure of the medical encounter, as traditionally
seen by health professionals, masks a deeper structure that may have little to do
with the conscious thoughts of professionals about what they are saying and doing.
Similar patterns may appear in encounters between clients and members of other "helping"
professions. Expressed marginally or conveyed by absence of criticism about contextual
issues, ideology and social control in medical discourse remain largely unintentional
mechanisms for achieving consent.