Studies on politeness in Korean — an honorific-rich language like Japanese — have focused more on what Sohn (1995: 408) identifies as ‘normative’ (or discernment) politeness. Whilst these studies are illuminating, they have paid little attention to the ‘dynamic’ aspect of politeness. That is, they have focussed on ‘static’ or primarily dyadic interactions and have explored the speaker’s discursive intention but paid minimal attention to the addressee’s evaluation of certain utterances. The present study attempts to fill this gap by showing how multiple levels of politeness arise at ‘situational, institutional, and societal levels’ (Fairclough, 1989) in Korean institutional discourse. To this effect, it concentrates on the interaction between Korean Oriental medical doctors and their patients, which is a ‘fruitful epistemological site’ (Sunderland, 2004: 73) for the study of emerging and situated politeness in Korean. This is particularly so because in Korea traditional and Western medicine co-exist — Western medicine often being regarded as ‘dominant’ one — and consequently there is a ‘dual medical authority’ in Korean society. Employing Goffman’s (1981) ‘participation framework’ and Davies and Harré’s (1990, 1999) ‘positioning theory’, the present article demonstrates that the dual medical authority often obscures the ‘speaker’, ‘addressee’, and (im)politeness of a speech act in patient–Oriental medical doctor interactions. An act that is apparently face-threatening at the situational level may not necessarily be face-threatening at the institutional level, where the ‘real’ addressee may be a non-present Western doctor or even Western biomedicine itself. The paper concludes that the dyadic, synchronic, and cross-sectional model of politeness on which most studies of Korean politeness rely is too simplistic and idealised. Instead, a multidimensional discursive approach to politeness should be adopted.