Non-discrete care: dialectical-relational CDA and the platformization of healthcare in Egypt

초록

This article examines Vezeeta, a leading Egyptian medical aggregator app, as a platformized site in which healthcare is reorganised through neoliberal discourse and interface governance. Drawing on Chouliaraki and Fairclough's dialectical-relational (DR) approach to critical discourse analysis, the study foregrounds the principle of non-discreteness, treating discourse as different from - yet inseparable from - material practice and institutional change. Conceptually, the article mobilizes orders of discourse to show how Vezeeta patterns and reorganizes discourses, genres, and styles in healthcare by mixing clinical and commercial genres, including menu-based 'services,' discount banners, loyalty points, and swipeable 'Featured Doctors' carousels. It then traces operationalization as the key mechanism through which dominant discourses are 'put to work' in routines, identities, time-space coordination, and interactional norms, recasting patients as consumer-evaluators and doctors as competitive, reputation-managed service providers. The analysis demonstrates how market logics become institutionalized through metricized reputation (stars, visitor counts, tags), technologized evaluation templates, and synthetic personalization that frames platform monitoring as friendly support. Situated within Egypt's fragmented, largely out-of-pocket health economy and contemporary UHC reform discourse, the article argues that Vezeeta actively contributes to their materialization, producing stratified access, new norms of 'good care,' and platform-dependent forms of medical visibility and authority.

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