Communication in Medical Care Interaction between Primary Care Physicians and Patients

This 2006 volume provides a comprehensive discussion of communication between doctors and patients in primary care consultations. It brings together a team of leading contributors from the fields of linguistics, sociology and medicine to describe each phase of the primary care consultation, identifying the distinctive tasks, goals and activities that make up each phase of primary care as social interaction. Using conversation analysis techniques, the authors analyze the sequential unfolding of a visit, and describe the dilemmas and conflicts faced by physicians and patients as they work through each of these activities. The result is a view of the medical encounter that takes the perspective of both physicians and patients in a way that is both rigorous and humane. Clear and comprehensive, this book will be essential reading for students and researchers in sociolinguistics, communication studies, sociology, and medicine.

1. Introduction: analyzing interaction between doctors and patients in primary care encounters John Heritage and Douglas W. Maynard; 2. Soliciting patients' presenting concerns Jeffrey Robinson; 3. Accounting for the visit: giving reasons for seeking medical care John Heritage and Jeffrey Robinson; 4. Realizing the illness: patients' narratives of symptom discovery Tim Halkowski; 5. Explaining illness: patients' proposals and physicians' responses Virginia Gill and Douglas W. Maynard; 6. Taking the history: questioning during comprehensive history taking Elizabeth Boyd and John Heritage; 7. Body work: the collaborative production of the clinical object Christian Heath; 8. Communicating and responding to diagnosis Anssi Peräkylä; 9. On diagnostic rationality: bad news, good news, and the symptom residue Douglas W. Maynard and Richard M. Frankel; 10. Treatment decisions: negotiations between doctors and patients in acute care encounters Tanya Stivers; 11. Prescriptions and prescribing: co-ordinating talk and text-based activities David Greatbach; 12. Lifestyle discussions in medical interviews Marja-Leena Sorjonen, Liisa Raevaara, Markku Haakana, Tuukka Tammi and Anssi Peräkylä; 13. Co-ordinating closings in medical interviews: producing continuity of care Candace West; 14. Mis-alignments in 'after-hours' calls to a British GP's practice: a study in telephone medicine Paul Drew.

In this 2006 volume, a team of leading contributors from the fields of linguistics, sociology and medicine examine how doctors and patients communicate in primary care consultations. Clear, informative and comprehensive, it will be essential reading for students and researchers in sociolinguistics, communication studies, sociology, and medicine.

John Heritage is Professor of Sociology at the University of California, Los Angeles.
Douglas W. Maynard is Professor of Sociology at the University of Wisconsin-Madison.