Missing assessments: Lay and professional orientations in medical interviews
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Charlotte M Jones
Associate Professor of Communication Studies at Carroll College. Her research focuses on the study of medically related interaction including provider–patient interviews, family therapy encounters, and support group meetings. Other areas of interest are the communication of social support and sensitivity in everyday and institutional settings.
Abstract
This study extends conversation analytic research by Frankel and colleagues on the occurrence (or nonoccurrence) of assessments in physician–patient interviews. As assessments are regularly offered after hearing news or information just asked for in everyday talk (often displaying alignment and as liation for the news bearer), and as reportings commonly occur in both mundane and medical interaction, the post-question–answer slot (after newsworthy answers) was identified as one interactional environment to investigate. Analysis revealed that lay and professional orientations do not mesh. At these points, assessments are absent, unlike in everyday talk. Instead, physicians offer (a) no response, or (b) an acknowledgment token. Patients subsequently exhibit, through pausing and withholding speaking, that they expect a different type of response from physicians. Hence, gaps occur when assessments might be due (from a mundane perspective), marking them as missing. After these gaps, the participants react differently. Physicians disattend the lack of assessments, instead continuing with ‘business at usual’. Patients display an orientation to the absence, using various strategies ‘unsuccessfully’. Implications are discussed in relationship to as liation and social support, important in the delivery of health care. Several explanations for absent assessments in medical interviews are also explored.
About the author
Associate Professor of Communication Studies at Carroll College. Her research focuses on the study of medically related interaction including provider–patient interviews, family therapy encounters, and support group meetings. Other areas of interest are the communication of social support and sensitivity in everyday and institutional settings.
© Walter de Gruyter
Articles in the same Issue
- Editorial
- Editorial: On demarcating the space between ‘lay expertise’ and ‘expert laity’
- Introduction: Diagnosing ‘lay diagnosis’
- Symmetry, asymmetry and ‘requests’
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- Accomplishing a request without making one: A single case analysis of a primary care visit
- Patient concerns
- Clinical care and conversational contingencies: The role of patients' self-diagnosis in medical encounters
- Missing assessments: Lay and professional orientations in medical interviews
- Further delicate moments in medical …
- Breaking the sequential mold: Answering ‘more than the question’ during comprehensive history taking
- Laughter as a patient's resource: Dealing with delicate aspects of medical interaction
- … and family interactions
- Stability and ambiguity: Managing uncertain moments when updating news about mom's cancer
- Commentaries
- Lay diagnosis in interaction
- Spotlight on the patient
Articles in the same Issue
- Editorial
- Editorial: On demarcating the space between ‘lay expertise’ and ‘expert laity’
- Introduction: Diagnosing ‘lay diagnosis’
- Symmetry, asymmetry and ‘requests’
- Asymmetry in action: Sequential resources in the negotiation of a prescription request
- Accomplishing a request without making one: A single case analysis of a primary care visit
- Patient concerns
- Clinical care and conversational contingencies: The role of patients' self-diagnosis in medical encounters
- Missing assessments: Lay and professional orientations in medical interviews
- Further delicate moments in medical …
- Breaking the sequential mold: Answering ‘more than the question’ during comprehensive history taking
- Laughter as a patient's resource: Dealing with delicate aspects of medical interaction
- … and family interactions
- Stability and ambiguity: Managing uncertain moments when updating news about mom's cancer
- Commentaries
- Lay diagnosis in interaction
- Spotlight on the patient
