ABSTRACT
Appropriate clinical communication between patients and physicians requires better cooperation based on patientphysician rapport and consensus development through information sharing.Developing appropriate clinical communication is also important for safer and more reliable clinical care. The aim of the present study was to illustrate an effective politeness strategy for appropriate clinical communication.<BR>1) We conducted focus-group interviews and performed qualitative analysis on the basis of the results of interviews of both patients and physicians.We also performed an Internet survey and organized an Internet-based discussion ofthe politeness strategy and its effectiveness.<BR>2) Patients may consider physicians' overuse of honorifics as feigned politeness, Both patients and physicians recognize that such overuse may work against the development of rapport-based cooperation.<BR>3) Patients may expect physicians to use simpler honorifics, such as “-san.”However, by using honorifics physicians can show respect to patients and establish a more intimate relationship with patients through both positive and negative politeness strategies.<BR>4) When physicians can better understand and use local dialects, the effects of positive politeness may reduce the psychological distance between patients and physicians, have a relaxing effect on patients, and improve clinical information gathering.<BR>5) A positive politeness strategy, such as admiring and talking optimistically, may have different effects depending on the patient's condition or“face.”If successful, this strategy can contribute to the behavioral changes of patients.