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Article published In: Pragmatics and Society
Vol. 17:1 (2026) ► pp.123–147

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Withholding advice for rapport management in online medical counselling interactions

A comparative perspective

ORCiD logo with link | Zhejiang Gongshang UniversityHangzhou
Published online: 14 April 2025
DOI logo with link
https://doi.org/10.1075/ps.19042.yan
Abstract
This paper investigates how male and female doctors manage rapport by withholding advice in online medical counselling interactions. Data were collected from 60 doctors’ replies in response to web users’ advice-seeking inquiries on the Chinese health care website ‘Good Doctor Online’. From a comparative perspective, the study examined the use of two advice withholding strategies for rapport management — challenging a patient and parading expertise. The findings show that (1) both male and female doctors use the strategies to mitigate their authoritative force and empower patients with autonomy; and (2) female doctors tend to get the patients more involved in the interaction, while male doctors remain relatively more authoritative in accounting for their withholding behaviour. This research contributes to the study of health communication and extends the investigation of advice withholding from general discussions into a comparative analysis.
Article outline
  • 1.Introduction
  • 2.Theoretical rationale
    • 2.1Advising as a face-threatening act
    • 2.2Withholding advice for managing rapport in OMC
    • 2.3Gender’s impact on doctors’ speech styles
  • 3.Data and methods
    • 3.1Data context
    • 3.2Ethical issues
    • 3.3Data sampling
    • 3.4Data analysis
  • 4.Findings
    • 4.1Advice withholding strategies in OMC
      • 4.1.1Challenging the patient
    • 4.2Parading expertise
    • 4.2Male doctors vs. female doctors
  • 5.Discussion
  • 6.Conclusion
  • Acknowledgements
  • Note
  • References
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