Patients initiating talk about symptoms that concern them

Posted on January 23, 2014 by


For the first Langwidge Sandwidge of this term we have Paul Drew (Loughborough), who will be presenting on Patients initiating talk about symptoms that concern them. The abstract is below.

The talk will be at 1pm on Tuesday 4th February in Samuel Alexander A202 (note change of venue from last term)!


Much of the research literature in medical interaction is concerned, understandably, with medical authority, arising from doctors’ medical knowledge and expertise. Studies focus on how medical authority is manifest and maintained in the consultation. So medical authority is linked to control over the interaction, through the interview format of the consultation – according to which, patient participation is limited to answering questions. In this way, the agenda is set by the doctor/professional, so that in this view patient concerns are subordinated to the medical agenda; the patient’s agenda is sidelined, unvoiced. It is arguable that this picture has emerged from focusing almost solely on primary care acute visits to the doctor, in general practice. A rather different picture emerges from secondary care, and primary care for chronic conditions. Based on data from UK ENT oncology and diabetes clinics, this presentation explores ways in which patients manage to ‘break free from’ the constraints of the interview format, initially through expansions, but then more significantly through patients’ initiations of talk about matters (usually symptoms) that concern them, unsolicited by doctors’ questions. These initiations represent the patient’s independent agenda. One point of interest for linguists is the way in which the language of optimism, by doctors, is met with some degree of resistance by patients.

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