1.1 Background to the study

Communication is a process in which a message is sent from sender to receiver. It is a practice that the sender encodes message and the receiver decodes it. Communication may occur in small groups or in organizations where there is work to do, or several small groups that need to interact among each other within a single organization. Gumperz (1982),states that communication is a ?social activity that requires the coordinated efforts of two or more individuals? that construct talk to produce sentences. However, no matter how well rounded or stylish the outcome may be, it does not by itself constitute communication. Communication takes place only when a common understanding is obtained among communicants. Therefore, it is necessary to have the knowledge and ability to create and sustain conversation. The knowledge also needs to be not only grammatical competence but also linguistic, socio-cultural knowledge, and understanding the nature of the conversation Gumperz (1982: 2).

Interpersonal communication is one type of communication, which is defined in many ways. Miller(1978) defines it based on the situation and number of participants involved and states that interpersonal communication occurs between two individuals when they are close in ?proximity, able to provide immediate feedback and utilize multiple senses?. Others such as Peters(1974) described interpersonal communication based on the degree of personal closeness? or perceived quality, of a given interaction; it includes communication that is private and occurring between people who are more than acquaintances. Canary(2003)view of interpersonal communication is from the perspective of conversant goals. According to Dainton(2004:50) states that communication is used to attain or achieve personal goals through interaction with others.

As one category of interpersonal communication, medical communication is central to clinical functions in constructing a good doctor ?patient relationship, which is one of the major tasks in medical profession. In this regard, Van Naerssen (1985) identifies two kinds of medical communication that includes doctor to patient and doctor to other medical personnel communications. Naerssen claims that, both kinds belong to different registers, each with a range of variations within it.? The first is the interaction between two medical professionals (doctor with nurse, doctor with doctor, as well as nurse with nurse). The second is, the interaction between medical professionals with their patients, which includes interviews - called ?chief complaint?, treatments, breaking bad news, consultation and follow-ups. Each part has its own structure and characteristic features that can be observed and analyzed either separately or as part of a larger discourse.

1.2 Statement of Research Problem

Having a good medical communication is important in the delivery of high-quality health care and has the potential to help regulate patients’ emotions, facilitate comprehension of medical information, and allow for better identification of patients? needs, perceptions, and expectations. Patients reporting good communication with their medical care professional are more likely to be satisfied with their care, and especially to share significant information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment Naerssen(1985: 44).

However, according to Naerssen, patients complain about their doctors that, they are not willing to listen, do not answer their questions, or inform them properly. In addition they are authoritative and unhelpful, at the same time; doctors criticize their patients for not following their advice Naerssen (1985: 43).

For code switching and code mixing to work properly, there should be background knowledge of more than one language by the parties involved, the absence of which may lead to ineffective switch and may sometimes lead to misconception of ideas, communication barrier and misinterpretation of messages. This research therefore investigates the role of code mixing and code switching in doctor-patient communication in Federal Medical Centre Katsina.

1.3 Research Question

In line with the problem of the research raised above, this work has the following research questions:

(i) Does problem of communication exist between doctors and patients at the Federal

Medical Centre Katsina?

(ii) What are the factors responsible for code mixing and code switching between doctors and patients?

(iii) What is the effect of professional background on effective communication between Patient and doctor?

(iv) What are the remedies to effective communication between doctors and patients?

1.4 Aim and Objectives of the study

Based on the research questions raised above, the research is guided by the following aim and objectives:

i. To investigate whether there are communication gaps between doctors and patients.

ii. To assess the factors responsible for code mixing and code switching.

iii. To examine the effect of professional background in effective communication between doctors and patients.

iv. To proffer better ways in which effective communication can take place between doctors and patients.

1.5 Significance of the study

This study investigates some of the important points regarding medical communication and content of the language from sociolinguistics and pragmatic aspects. In other words, the study attempts to describe issues, which are related to language use and implications in communication. Therefore, the study, first, helps patient and medical professionals to know the importance of communication in asserting themselves while talking to each other. Second, it gives an idea or a hint about medical communication for medical professionals on how to talk and handle their patients. Third, it will serve as a resource for future researchers

1.6 Scope of Study

This study is carried out within the Federal Medical Centre (FMC) Katsina. The study is also limited to the interview aspects that the medical professional holds with the patients, which contains the most prominent aspect of the interaction that fully employs the use of conversation. Moreover, it is obvious that medical communications are not conducted only orally but through writing, too. However, the study focuses only on the oral interaction. The excluded area, that is, the written communication will be relevant to the analysis of prescription, medication, and reports in medical records. The study also excludes the interaction between doctors with other medical personnel, in order to pay particular attention to Doctor ? Patients interaction.