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“If you don’t get better, you may come back here”: proposing conditioned follow-ups to the doctor’s office

  • Søren Beck Nielsen

    Søren Beck Nielsen, PhD, is Associate Professor in the field Psychology of Language at University of Copenhagen. His main research area is oral health communication. Using conversation analysis, he has investigated various types of communication in health-care encounters, notably in geriatric wards and in general practice. He has previously published his research in journals such as Research on Language and Social Interaction, Discourse Studies, Pragmatics and Society, Time & Society and Communication & Medicine.

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Published/Copyright: February 27, 2018

Abstract

Previous research has established that conversationalists treat “arrangement making” as closure implicative contributions. This study adds “conditioned arrangement making” to the list with an examination of how general practitioners propose conditioned follow-ups to patients, that is, the opportunity to return to the clinic if their condition does not improve or if it should worsen. The data consists of 52 audio-/video-recorded naturally occurring general practice consultations in Denmark. Using the conversation analytic method, the paper examines why the hypotheticality of this particular kind of proposition making is a resource for practitioners in terms of accomplishing progression towards termination of the consultation, and also in terms of accomplishing agreement upon appropriate, responsible and reassuring treatment plans. Among other things, conditioned follow-up propositions enable doctors to communicate “no problem” diagnoses while preserving care continuity. The study, therefore, contributes to the understanding of how use of grammatical formats such as conditional clauses influences institutional interaction.

About the author

Søren Beck Nielsen

Søren Beck Nielsen, PhD, is Associate Professor in the field Psychology of Language at University of Copenhagen. His main research area is oral health communication. Using conversation analysis, he has investigated various types of communication in health-care encounters, notably in geriatric wards and in general practice. He has previously published his research in journals such as Research on Language and Social Interaction, Discourse Studies, Pragmatics and Society, Time & Society and Communication & Medicine.

Appendix. Transcription symbols

[

the beginning of overlapping speech

]

the end of overlapping speech

(.)

a pause under 0.2 seconds

(0.5)

a pause measured in seconds

(comment)

comment about the translation

=

uttered with no pause at all

wo:

prolonged sound

word

emphatic

˚word˚

soft spoken

<word>

slow speech

>word<

fast speech

.h

in-breath

wo(h)rd

laughing voice

heh heh

laughter

wor-

a cut-off, i.e. a sudden speech stop

XX

unintelligible

*

notation of embodied conduct that coincides with speech

↑word

rising intonation

↓word

falling intonation

punctuation mark after turn-unit.

falling prosody

comma after turn-unit,

steady prosody

question mark after turn-unit?

rising prosody

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Published Online: 2018-2-27
Published in Print: 2018-2-23

© 2018 Walter de Gruyter GmbH, Berlin/Boston

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