Genre Analysis Kristy Gonzalez

9/23/2013 7:52:00 AM

According to John M. Swales, a discourse community is a community of people in which the people within it have common goals and interests (Swales, 2011). One day I hope to be a part of he medical discourse community with the common goal of helping people feel better and to save lives. After looking through texts from this discourse community, I decided to go with three patient history forms. One is from Nova Southeaster Universitys health center, another is from Palo Alto Medical Foundation, and the last is from Johns Hopkins. The specific genre that I have chosen to work with is patient history forms. The goal of this discourse community in using these patient history forms is to be fully aware of and medical problems that the patient might have now or be aware of the possibilities that might arise in the future for that specific patient. Their ultimate goal is to keep the patient healthy. All three forms are used by all of the members of this discourse communities in many ways to achieve their goals. Every person within the discourse community has a different type of interaction with it. If it is the patient, they read and fill out the form then once it is signed it becomes a legal document. The receptionists usually input a lot of this answered information into a database and the doctor uses it to try and diagnose the issue based on previous medical history. In this genre analysis I will examine each document separately then look at them as a whole and compare and contrast the three separate forms. The first document is the one from Nova Southeastern University. As you can see in appendix I, this form is one page long. It is front and back and really straight to the point. Mostly all the questions on this for are in the form of check boxes, either yes or no. There are few written answers. This may be because when you think of the person who if going to examine this document, its mostly going to be the doctor. Doctors tend to have really busy schedules and not a lot of time per patient. So it seems like this form only asks the most important questions and based on those answers more questions may arise. So this is almost like a filter. It filters out all the things that are most likely not relevant to the patient by asking specific questions that will act as a cue to other questions that are not on the form.

The second document is from Palo Alto Medical Foundation. As you can see from appendix II it is three times longer then the former history form that we looked at. It is a lot more thorough and personal with all the questions being asked. This form may take longer to read but it may help the doctor avoid missing any important information that may be key to the patients health. This form uses a lot of short hand that is most probably only understood by the doctor, nurses, and the office employees of that medical center. It doesnt seem like the average patient would be able to understand the meaning behind a lot of the questions but would just be able to check yes or no. The third document is from John Hopkins. It is not as long as the previous but still longer then appendix I. Some relevant background information is that this hospital is one of the best in the entire country. It holds world renowned doctors and so I would expect that they have a very thorough form to help ensure the best possible care. This form as you can see in appendix III, not only asks about the present but goes into just as much detail about the past if not more. It also has a lot of short hand, it avoids full sentences and makes use of check boxes as well. It keeps it thorough yet concise. Looking at all three documents as a whole, you can right away see that there are many similarities. They all start by asking the name of the patient. Then the rest of the forms are just questions that will tell the doctor everything that they need to know about your medical status. This includes symptoms, immunizations, past surgeries, past medical treatments, current medication, health history about family, and so on. They all have a very similar set up as well, simple and concise. In terms of how it was constructed, it was made in a way that anyone could easily understand how to fill it out. Also in all three forms the directions are always bolded as well as any important info that must be filled out. I noticed that none of the forms ask about any insurance information or anything dealing with how they are planning to pay. That means that their main focus is on the patients health rather then the patients wallet. Between the three forms Novas form seems to be the shortest. It is not nearly as thorough as the others are and maybe doesnt achieve the goal of the discourse community as well as the

others do. The longest and most thought out one would be Palo Alto Medical Centers. Their form asks any possible question you could think of. None of these forms use any type of pathos at all. Most of it is all logos. There is very little ethos, just with the name of the medical group at the top. With these types of forms the only people who are invited to interact with this text is the patient, the receptionist, the nurse, the insurance companies and the doctor. This is mainly because it is personal and confidential information. Those same people are also the people that have access to get this form but few people probably truly understand how to take the information one step further and make meaning out of it and relate it all together. It is the doctor and physicians assistants who have the training to do this, although its self explanatory how to fill out the form, that information doesnt mean anything unless you now how to interpret it, which is where the experts comes in. This genre is repeatedly asking the same rhetorical question, What is the medical problem with the patient? This genre helps all the people involved solve that question to achieve the common goal, which is to see the patient healthy. Although each form may be different from each other, in he end it all fits the same function.

WORKS CITED

Swales, John. The Concept of Discourse Community. Writing About Writing: A College Reader. Ed. Elizabeth Wardle and Doug Downs. Boston: Bedford/ St. Martins, 2011. 466-479. Print.

APPENDIX I

APPENDIX I

APPENDIX II

APPENDIX II

APPENDIX II

APPENDIX II

SURGICAL HISTORY Continued: Surgical Procedure Knee Surgery LEEP (Cervix Surgery) Neck Surgery Ovary Ligation (Tubal) Ovary Removal Vasectomy Sigmoidscopy Sinus Surgery Other (list)

Code

Yes

Year

Comments Circle: Right Left Both

Circle: Right Left Both

Adopted Yes No (Please Circle) If yes and you do not know your family history skip this section and continue to page 5 (Other Health Issues) FAMILY HISTORY Indicate which relative has had the following diseases (parents and siblings are most important).
Moms Mom Moms Dad Dads Mom Dads Dad Brother(s) Sister(s) Mother

Disease

Father

Other Relative

Comments

No significant history known Alcoholism / Drug abuse Alzheimers Asthma Autoimmune Disease Bleeding or Clotting Disorder Cancer Breast Cancer Colon Cancer Other Type Cancer Ovarian Cancer Prostate Colon Polyp Coronary Artery Disease (e.g. heart attack, angina) Depression / Suicide / Anxiety Diabetes (childhood onset) Diabetes (adult onset) Emphysema (COPD) Genetic Disorder (explain) Glaucoma Heart Disease (CHF) Heart Disease (Other) Hepatitis B or C High Blood Pressure - Hypertension High Cholesterol Hip Fracture Hypothyroidism / Thyroid Disease Kidney Disease Kidney Stones Macular Degeneration Migraine Headaches Osteoporosis Other (list)
Revised 3/10/11 Page 4 of 5

APPENDIX II

PATIENT HISTORY FORM

Date: _______/_________/________ NAME:
Last First M. I.

Birthdate: _____/______/_____

Age:___________ Sex: F M How did you hear about this clinic? Describe briefly your present symptoms:

Please list the names of other practitioners you have seen for this problem:

Psychiatric Hospitalizations (include where, when, & for what reason):

Have you ever had ECT?

CURRENT MEDICATIONS

Have you had psychotherapy?

Drug allergies: No Yes To what? Please list any medications that you are now taking. Include non-prescription medications & vitamins or supplements: Name of drug Dose (include strength & number of pills per day) How long have you been taking this? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

PAST MEDICAL HISTORY Do you now or have you ever had: Diabetes High blood pressure High cholesterol Hypothyroidism Goiter Cancer (type) _________________ Leukemia Psoriasis Angina Heart problems Other medical conditions (please list): Heart murmur Pneumonia Pulmonary embolism Asthma Emphysema Stroke Epilepsy (seizures) Cataracts Kidney disease Kidney stones Crohns disease Colitis Anemia Jaundice Hepatitis Stomach or peptic ulcer Rheumatic fever Tuberculosis HIV/AIDS

12.

PERSONAL HISTORY Were there problems with your birth? (specify) Where were your born & raised? What is your highest education?

High school Some college College graduate Advanced degree Marital status: Never married Married Divorced Separated Widowed Partnered/significant other
What is your current or past occupation? Are you currently working? : Yes No Do you receive disability or SSI? Yes No Have you ever had legal problems? (specify) Religion: Hours/week ______ If not, are you retired disabled sick leave?

If yes, for what disability & how long?___________________________

FAMILY HISTORY Age (s) Father Mother Siblings IF LIVING Health & Psychiatric Age(s) at death IF DECEASED Cause

Children

EXTENDED FAMILY PSYCHIATRIC PROBLEMS PAST & PRESENT: Maternal Relatives: Paternal Relatives:

SYSTEMS REVIEW In the past month, have you had any of the following problems?
GENERAL Recent weight gain; how much____ Recent weight loss: how much____ Fatigue Weakness Fever Night sweats MUSCLE/JOINTS/BONES Numbness Joint pain Muscle weakness Joint swelling Where? EARS Ringing in ears Loss of hearing EYES Pain Redness Loss of vision Double or blurred vision Dryness THROAT Frequent sore throats Hoarseness Difficulty in swallowing Pain in jaw HEART AND LUNGS Chest pain Palpitations Shortness of breath Fainting Swollen legs or feet Cough NERVOUS SYSTEM PSYCHIATRIC

Headaches Dizziness Fainting or loss of consciousness Numbness or tingling Memory loss

STOMACH AND INTESTINES

Nausea Heartburn Stomach pain Vomiting Yellow jaundice Increasing constipation Persistent diarrhea Blood in stools Black stools
SKIN

Redness Rash Nodules/bumps Hair loss Color changes of hands or feet

BLOOD

Depression Excessive worries Difficulty falling asleep Difficulty staying asleep Difficulties with sexual arousal Poor appetite Food cravings Frequent crying Sensitivity Thoughts of suicide / attempts Stress Irritability Poor concentration Racing thoughts Hallucinations Rapid speech Guilty thoughts Paranoia Mood swings Anxiety Risky behavior
OTHER PROBLEMS:

Anemia Clots
KIDNEY/URINE/BLADDER

Frequent or painful urination Blood in urine

Women Only: Abnormal Pap smear Irregular periods Bleeding between periods PMS

WOMENS REPRODUCTIVE HISTORY:

Age of first period: # Pregnancies: # Miscarriages: # Abortions: Have you reached menopause? Y / N Do you have regular periods? Y/ N

At what age?

SUBSTANCE USE
DRUG CATEGORY (circle each substance used) Age when you first used this: How much & how often did you use this? How many years did you use this? When did you last use this? Do you currently use this?

ALCOHOL CANNABIS: Marijuana, hashish, hash oil STIMULANTS: Cocaine, crack STIMULANTS: Methamphetaminespeed, ice, crank AMPHETAMINES/OTHER STIMULANTS: Ritalin, Benzedrine, Dexedrine BENZODIAZEPINES/TRANQUILIZERS: Valium, Librium, Halcion, Xanax, Diazepam, Roofies SEDATIVES/HYPNOTICS/BARBITURATES: Amytal, Seconal, Dalmane, Quaalude, Phenobarbital HEROIN STREET OR ILLICIT METHADONE OTHER OPIOIDS: Tylenol #2 & #3, 282S, 292S, Percodan, Percocet, Opium, Morphine, Demerol, Dilaudid HALLUCINOGENS: LSD, PCP, STP, MDA, DAT, mescaline, peyote, mushrooms, ecstasy (MDMA), nitrous oxide INHALANTS: Glue, gasoline, aerosols, paint thinner, poppers, rush, locker room OTHER: specify)_______________________________ _____________________________________ _____________________________________

Yes Yes

No No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes Yes Yes

No No No

Yes

No

Yes

No

Yes

No