The structure of patients' presenting concerns: the completion relevance of current symptoms.
This article uses conversation analysis to investigate the problem-presentation phase of 302 visits between primary-care physicians and patients with acute problems. It analyzes the social-interactional organization of problem presentation, focusing on how participants recognize and negotiate its completion. It argues that physicians and patients mutually orient to the presentation of current symptoms--that is, concrete symptoms presented as somehow being experienced in the here-and-now--as a locus of transition between the patient-controlled problem-presentation phase of the visit and the physician-controlled information-gathering phase. This is a resource for physicians to distinguish between complete and incomplete presentations, and for patients to manipulate this distinction.
Robinson
Jeffrey D
JD
Department of Communication, Rutgers University, New Brunswick, NJ 08901-1071, USA. jrob@scils.rutgers.edu
Heritage
John
J
D000208:Acute Disease; D003142:Communication; D003937:Diagnosis, Differential; D006801:Humans; D009819:Office Visits; D010358:Patient Participation; D010817:Physician-Patient Relations; D014481:United States; D014743:Videotape Recording