Att söka vård med text.: Egenremissen som genre

Abstract

This article explores an emerging genre in Sweden: self-referral letters. Although written by the patients themselves, self-referrals have the same objective as a doctor’s referral: to refer someone to specialist care. In relation to previous research, these texts shed light on a new type of writing that some patients engage in, but that requires literacy and rhetorical skills that are presumably not available to everyone. The data consist of self-referrals written by women seeking care for endometriosis, and interviews with some of these women. Using genre as a guiding concept, the analysis explores both the linguistic and semiotic resources that are drawn on in the texts, and the textual potentials and limitations that patients identify when writing. Results show that the self-referrals attend to expectations about medical expertise. For instance, writers use formal and familiar voices to legitimize the need for care, and incorporate elements of medical discourse when presenting symptoms. Parallels can also be drawn between the doctor-patient relationship represented in the texts and a traditional doctor’s visit: doctors are often positioned as knowledgeable interpreters of the information, whereas patients describe themselves as moral and rational. The article concludes that even though the self-referrals enable patients to seek care in an alternative way, they are constrained by several genre expectations and a traditional division of labor between doctors and patients.