The use of linguistic metaphors in General Practice. Awareness and perceived usefulness in a Primary Care group

Aim and background. In the field of General Practice (GP), metaphors have been studied as communication strategies that have an impact on the quality of care, especially if expressed by patients, and less by physicians. There are no studies on the reflection of physicians on their deliberate use of metaphors. The actual debate is divided: are metaphors useful or dangerous tools? Our research question was to understand the representation of the use of metaphors by physicians, nurses and administrative assistants of a Primary Care Group (PCG). Material & method. We chose the methodology of the Interpretative Phenomenological Analysis (IPA), and followed the case study strategy, purposefully selecting a PCG in Northern Italy. Ten physicians, 3 administrative assistants, and 2 nurses (10 females, 5 males) were interviewed. Semi-structured interviews were focused on the use of metaphors from participants and patients, and on the use of metaphors in their professional education. Results. According to participants, the representations of metaphors were different if the expressions came from the physicians or the patients. The recognition of metaphors also varied for each participant. Advantages and threats were indicated on the clinical use of these expressions. Moreover, metaphors were used unconsciously to explain some concepts, such as patient education, the effects of clinical language on patients, and the professional identity. Conclusions. Metaphor was represented as an epistemological, relational, and ontological phenomenon. Because of the qualitative impact of these expressions in GP, we believe that it could be useful for students/health-professionals to learn to recognize and to use metaphors consciously, by creating curricula specifically designed for this aim.