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Abstract

In bilingual regions such as Galicia, Spain, where Galician and Spanish are co-official languages, interactions frequently involve code-switching, the alternation between languages within a conversation. This dissertation examines how code-switching is employed in primary care medical consultations, focusing on how bilingual family doctors and patients alternate between Galician and Spanish to achieve both transactional (addressing health issues) and interpersonal (building rapport) goals. Using a mixed-methods approach, the study analyzes two complementary datasets from the same speech community: (a) 586 audio-recorded consultations and 8 semi-structured interviews with family doctors, and (b) 208 questionnaires and 15 semi-structured interviews with prospective patients. This combination of data enables a comprehensive comparison between the reported language behavior and actual language use in medical consultations. The findings reveal three key dynamics of code-switching in medical consultations: social, interpersonal, and situational. Social dynamics reflect how doctors and patients negotiate language choices depending on language competencies, preferences, and broader sociolinguistic patterns inside and outside the doctor's office. Interpersonal dynamics demonstrate that code-switching regulates social distance —switches to Galician often foster closeness and trust, while switches to Spanish can reinforce professional authority. Situational dynamics indicate that code-switching patterns vary across consultation stages, serving functions such as clarifying information, enhancing understanding, managing topic shifts, and facilitating sensitive discussions. Overall, this research contributes to our understanding of bilingual healthcare communication, demonstrating that code-switching is a strategic tool for enhancing doctor-patient interactions. The findings inform language policy discussions in bilingual regions and suggest practical approaches for more effective healthcare delivery in multilingual settings.