Heritage2011e

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Heritage2011e
BibType ARTICLE
Key Heritage2011e
Author(s) John Heritage
Title The interaction order and clinical practice: Some observations on dysfunctions and action steps
Editor(s)
Tag(s) EMCA, Conversation Analysis, Medical EMCA, Problem Presentation, Medical Questioning, Patient Resistance
Publisher
Year 2011
Language
City
Month
Journal Patient Education and Counseling
Volume 84
Number 3
Pages 338–343
URL Link
DOI 10.1016/j.pec.2011.05.022
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Objective This paper examines three dysfunctional communication processes in the primary care consultation using conversation analysis theory and methods: dysfunctions in problem presentation, medical questioning that limits the expression of additional concerns, and the emergence of discordance between physicians and patients in the context of treatment recommendations.

Results It is proposed that these dysfunctions arise from the transfer of normative conventions that function well in the practice of ordinary conversation into medical contexts where they serve to limit the effectiveness of communication. Because these conventions are rooted in, and reinforced by, the activities of daily life, they may be difficult to eradicate from the medical visit.

Practice implications Reduction of these dysfunctions is most likely to emerge when physicians recognize the nature of these dysfunctional practices and their roots in everyday social life. Recognition of these practices together with their functions and dysfunctions may hold a solid prospect for improvements in medical communication.

Notes