The Influence of Everyday Interpersonal Communication on the Medical Encounter: An Extension of Street’s Ecological Model

ABSTRACT

Street’s ecological model has shaped the research-examining communication during medical encounters for over a decade. Although the model accounts for the variety of contexts that shape the conversations in which patients and health-care providers engage, the model does not adequately address the way that everyday conversations about health carry over into patient–provider interactions. In this essay, we propose an extension of Street’s model that adds the context of everyday communication about health as a contributing factor in the medical encounter. We support the need for this extension by discussing research that points to the ways these conversations with our social network influence communication during the medical encounter and propose new areas for research based on this extension.

Acknowledgments

This essay was inspired by not only our own observations about the influence of everyday interpersonal communication about health on patient–provider interactions, in our own lives and in our own research, but also by a panel at the 2016 Kentucky Conference on Health Communication devoted to the current state of research on the ecological model and precision medicine. The authors wish to thank Dr. Rick Street for a conversation that led to this manuscript and to thank Dr. Nancy Grant Harrington for her helpful comments on an early draft of this manuscript.