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We have previously shown that patients' perceptions of doctor empathy also support positive experiences at an online clinic. However, there is still little knowledge about what types of communication influence patients\u2019 online experiences of empathy. In this study we investigated text-based patient-doctor discourse at an online clinic using an adaptation of the Roter Interaction Analysis System (RIAS). Our aims were 1) to assess the reliability of the adapted RIAS 2) to investigate what characteristics are common during the text-based consultations and 3) to examine how the doctor\u2019s discourse relates to the patients\u2019 experience of empathy online. Based on the inter-rater reliability analyses the conversational clusters of Social (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.950), Biomedical (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.939), and Technology related talk (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.833), Procedural statements (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.693) and Agreement (<jats:italic>\u03c1<\/jats:italic> \u2009=\u20090.687) were rated with acceptable reliability. Biomedical topics were most common in both patients\u2019 and doctors\u2019 communication. Patients\u2019 experience of doctors\u2019 empathy was positively correlated with the amount of doctor\u2019s psychosocial talk and procedural statements although the effect sizes were small (<jats:italic>\u03c1<\/jats:italic> \u2009&lt;\u20090.30 for all models). These results encourage the use of personal talk and giving clear instructions to patients about the care process at a text-based online clinic focusing on brief consultations.<\/jats:p>","DOI":"10.1007\/s10606-023-09481-8","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T06:01:48Z","timestamp":1697695308000},"page":"1151-1175","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Text-based Patient \u2013 Doctor Discourse Online And Patients\u2019 Experiences of Empathy"],"prefix":"10.1007","volume":"33","author":[{"given":"Silja","family":"Martikainen","sequence":"first","affiliation":[]},{"given":"Laura","family":"Kohonen-Aho","sequence":"additional","affiliation":[]},{"given":"Niina","family":"Seittenranta","sequence":"additional","affiliation":[]},{"given":"Emilia","family":"Makkonen","sequence":"additional","affiliation":[]},{"given":"Mari","family":"Falcon","sequence":"additional","affiliation":[]},{"given":"Valtteri","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[]},{"given":"Katri","family":"Saarikivi","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"9481_CR1","doi-asserted-by":"crossref","unstructured":"Arminen, Ilkka; Christian Licoppe; and Anna Spagnolli (2016). 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