The rhetoric of health and medicine (or medical rhetoric) is an academic discipline concerning language and symbols in health and medicine. Rhetoric most commonly refers to the persuasive element in human interactions and is often best studied in the specific situations in which it occurs. As a subfield of rhetoric, medical rhetoric specifically analyzes and evaluates the structure, delivery, and intention of communications messages in medicine- and health-related contexts. Primary topics of focus includes patient-physician communication, health literacy, language that constructs disease knowledge, and pharmaceutical advertising (including both direct-to-consumer and direct-to-physician advertising). The general research areas are described below. Medical rhetoric is a more focused subfield of the rhetoric of science.

Practitioners from the medical rhetoric field hail from a variety of disciplines, including English studies, communication studies, and health humanities. Through methods such as content analysis, survey methodology, and usability testing, researchers in this sphere recognize the importance of communication to successful healthcare.

Several communication journals, including Communication Design Quarterly, Journal of Business and Technical Communication, Technical Communication Quarterly, and Present Tense, have published special issues on themes related to medical rhetoric. The majority of research in the field is indexed in the academic database EBSCO Communication & Mass Media Complete. In 2013, scholars in the field also began a biennial symposium, Discourses of Health and Medicine.

History of the field

The rhetoric of health and medicine is tied to the emergence of rhetoric of science in the early 1970s and 1980s. Contemporary theorists such as Kenneth Burke, Michel Foucault, Thomas Kuhn, Bruno Latour, and Steve Woolgar laid the theoretical groundwork for this early interest in the persuasive dimensions of scientific language. In the 1980s the field shifted when rhetorical critics like Martha Solomon and Charles Anderson began analyzing texts on biomedicine. Solomon analyzed the rhetoric used in medical reports during the Tuskegee Syphilis Project, while Anderson examined the writings of surgeon Richard Selzer to comment on the rhetoric of surgery.

In the 1990s, the rhetoric of health and medicine emerged more clearly as a field distinct from rhetoric of science. Rhetorical scholar Celeste Condit raised questions about the historical and rhetorical dimensions of issues like abortion and genetics in works such as 1990's Decoding Abortion Rhetoric: Communicating Social Change and 1999's The Meanings of the Gene: Public Debates about Heredity. In these seminal works, Condit focused on what she called "rhetorical formations," or the multiple simultaneous discourses that surrounded each rhetorical object.

The field also saw the rise of discussion on disability studies and illness narratives during the 1990s, which initiated the beginning of a Special Interest Group on disability studies at the annual Conference on College Composition and Communication (CCCC), headed by Brenda Jo Brueggemann. The initiation of this group then inspired a Medical Rhetoric Special Interest Group, headed by Barbara Heifferon, which has continued to meet annually to present day.

In the early 21st century, scholars began to pay increasing attention to various topics in the rhetoric of health and medicine. J. Blake Scott's 2003 book Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing used Michel Foucault's theory of examination, which defines rhetoric as a form of disciplinary power, to examine the cultural condition that influence HIV testing. He reported that the rhetoric used in public policy and various propaganda led to the stigmatization and discrimination of people with HIV/AIDS.

In 2005, Judy Segal's Health and the Rhetoric of Medicine gained recognition for highlighting the persuasive elements in diagnoses, health policies, illness experiences, and illness narratives. She also addressed direct-to-consumer advertising of prescription drugs, the role of health information in creating the "worried well", and problems of trust and expertise in doctor-patient relationships.

In 2010, Lisa Keränen's Scientific Characters: Rhetoric, Politics, and Trust in Breast Cancer Research addressed issues of research viability and relationships among scientists, patients, and advocates. Kimberly Emmons’ work on the rhetoric surrounding depression, Black Dogs and Blue Words: Depression and Gender in the Age of Self-Care, was published the same year.

In 2018, Methodologies for the Rhetoric of Health & Medicine, edited by Lisa Melonçon and J. Blake Scott, was published, examining various methodologies in the field of rhetoric of health and medicine.

Research areas

Rhetoric of pharmaceutical and science commercialization

The rhetoric of pharmaceutical and science commercialization is the study of the persuasive language and symbols that the pharmaceutical industry and biotechnology companies use to communicate and influence consumers, physicians, regulatory agencies, and other stakeholders in the commercialization of biotechnology. Scholars have found that the language used to define, describe, and regulate pharmaceuticals influences the understanding and perception of the drugs among both the general publicSegal, Judy Z. “What, in Addition to Drugs, Do Pharmaceutical Ads Sell? The Rhetoric of Pleasure in Direct-to-Consumer Advertising for Prescription Pharmaceuticals.” Rhetorical Questions of Health and Medicine. Ed. Joan Leach and Deborah Dysart-Gale. Lanham, MD: Lexington Books, 2010. and experts. Information about pharmaceutical products is highly regulated and filtered through many channels as it moves from scientist to consumer.Bernick, Philip, Stephen Bernhardt, and Gregory Cuppan. “The Genre of the Clinical Study Report in Drug Development.” Rhetoric of Healthcare: Essays toward a New Disciplinary Inquiry. Ed. Barbara Heifferon and Stuart C. Brown. New York: Hampton Press, 2008. Print. Despite the regulations on pharmaceutical advertising, pharmaceutical companies use carefully crafted direct-to-consumer advertising to rhetorically influence the patient-physician dialogue to drive consumption of specific pharmaceutical drugs. Furthermore, pharmaceutical companies mislead physicians and scientists through deceptive rhetorical strategies in technical documentation (which both package inserts directed towards physicians and medical journal articles directed towards scientists). In a recent study, a pharmaceutical company disguised negative performance in one group of subjects by selectively merging data between different patient groups in clinical trials and carefully crafting supporting statements.Mogull, Scott A. (2017). Science vs. science commercialization in neoliberalism (extreme capitalism): Examining the conflicts and ethics of information sharing in opposing social systems. In H. Yu & K. M. Northcut (Eds.), Scientific Communication: Practices, Theories, and Pedagogies. New York: Routledge. This study shows that scientific data and knowledge is secondary to rhetorical messages supporting commercialization, and that human health is secondary to company profit. Notably, technical information is subject to obfuscation and distortion so that the message communicated outside of a commercial organization aligns with the primary goal of selling a product. Studying and trying to improve the rhetorical processes involved in pharmaceutical information as it moves through the chain of dissemination is a key concern of rhetorical scholarship on this topic.

Rhetoric of mental health

The rhetoric of mental health considers how language functions in the production of knowledge on topics such as mental and psychological disorders, chemical imbalances in the brain, and variations on what are considered normal mental faculties. The $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, introduced by the Obama administration in 2013, is testament to the emerging importance of brain science and mental health in medical science and public policy debate. Neurorhetoric, the study of how language is used in the creation, distribution, and reception of science about the brain, has recently become an important topic in medical rhetoric and composition studies, as well as in popular science publications targeted at non-scientists. Information and texts relevant to the rhetoric of mental health include psychotropic pharmaceutical regulations, their production, prescription, advertising, and consumption, and scientific and popular discussions about major depressive disorder, bipolar disorder, obsessive-compulsive disorder, schizophrenia, autism, and other mental disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM, now in its 5th edition) is a central text for the study of the mental health profession.

Patient narrative

Patient narrative is the clinical story of a person's past and present medical history documented by a medical clinician. The patient narrative can also be referred to as the medical history, the History and Physical (H & P), or the clinical narrative. The H&P includes a Subject, Objective, Assessment, and Plan (SOAP note), which summarizes the patient's narrative or history of medical illness, objectively reports the patient's clinical data and lab results, assesses diagnoses and prognoses, and often recommends how to address the patient's clinical situation. As part of the American Recovery and Reinvestment Act of 2009, the government enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act, which mandates that health providers transition from handwritten (typed) patient narratives to electronic patient narratives in forms such as the electronic medical record (EMR) or the electronic health record (EHR).Park, Seung L., Anvil V. Parwani, and Liron Pantanowitz. “Electronic Medical Records.” Practical informatics for Cytopathology 14 (2014): 121-127. The EMR and EHR are of interest to communication scholars because they economize the words and space of the traditional patient narrative into a structured system of navigation screens and checkboxes.

Rhetorics of alternative medicine

The rhetoric of alternative medicine differs from traditional medical rhetoric in its emphasis on the persuasive aspects of language related to holistic or other nonstandard approaches. Some of these alternative medical practices include acupuncture, massage therapy, and chiropractic care. Scholars further explore alternative medical practitioners’ claims that they take a holistic approach to medical treatment, assessing a person's body, mind, and spirit, rather than just treating a disease."FAQs." FAQs. American Holistic Medical Association (AHMA), n.d. Web. 31 Jan. 2014. <>.

Patient-physician communication