Kushida2020

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Kushida2020
BibType ARTICLE
Key Kushida2020
Author(s) Shuya Kushida, Michie Kawashima, Tetsuya Abe
Title Why this clinic now? A context-sensitive aspect of accounting for visits
Editor(s)
Tag(s) EMCA, Japan, Doctor-patient interaction, Primary care, Problem presentation, Free access system
Publisher
Year 2020
Language English
City
Month
Journal Social Science & Medicine
Volume 265
Number
Pages eid: 113278
URL Link
DOI 10.1016/j.socscimed.2020.113278
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

In presenting problems in medical consultations, patients face the task of justifying their visit to the doctor. Previous studies have shown that patients establish the legitimacy of their visit by characterizing their problem as “doctorable” and presenting themselves as reasonable patients (Halkowski 2006; Heritage & Robinson 2006). This study explores a context-sensitive aspect of this justification issue by analyzing patients’ first visits to a department of general medicine under the Japanese “free access” system. Patients are shown to present their problem in a way that conveys its relevance to the particular medical setting: they characterize their problem as suitable for relatively high-level medical care or as not easily falling under other specialties. The patient's problem's relevance to the setting is treated as normative in that participants take measures to remedy the possible mismatch between the problem and the setting. The institutional arrangement of the Japanese free access system is “talked into being” as a relevant context for the consultations through the practices participants use to establish the legitimacy of their visits.

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