The article is devoted to the peculiarities of the use of medical discourse in the denotative medical narrative, which is implemented in the doctor / patient dialogue. Concrete speech strategies and tactics of medical discourse in their application to the spoken language and the language of the media are considered. The semantic attribute “disease” marks the intersection of the discursive field of medicine with the political and socio-political discourse in a particular media text and creates a metatext thematic whole in the language of the media space. This semantic center, possessing the property of attracting and revealing thematically close lexical groups, creates a conceptual complex, which is the basis not only for contextually developed metaphors, but also for the metaphor-narrative that develops in parallel. The authors also analyze the cases of transition of denotative medical discourse into a metaphorical one. Speech strategies and tactics are explored in connection with the use of medical discourse as a metaphorical language in the media and media. The levels of functioning of the medical discourse, which provide two types of narrative - denotative medical and medical metaphoric, are highlighted. The strategies of uncertainty and substitution tactics in political discourse are analyzed. Medical discourse develops through the use of various strategies and tactics that are implemented in media texts and media. At all discursive levels, the doctor / patient dialogue structure is clearly indicated, which at different levels is presented in peculiar persuasive speech strategies and tactics.