title: Understanding communication between surgeon and patient in outpatient consultations.
abstract: BACKGROUND
  There is an assumption that there is a similarity between surgeon-patient and primary care consultations. Yet, surgeon communication has had far less analytic attention than its primary care counterparts. Therefore, this assumption of similarity (and the proposition here of dissimilarity) has yet to be evidenced through detailed interactional analysis.
  
  
  METHODS
  Conversation analysis (CA) is a methodology used to understand both mundane and institutional interactions. Using CA, we have developed an understanding of surgeon-patient interactions in outpatient clinic settings in New Zealand. Rather than attempting to determine what 'bad' communication is, we describe and analyse what occurs routinely in surgeon-patient consultations, particularly how these interactions are built up by both patient and doctor.
  
  
  RESULTS
  This research shows that while surgeon-patient consultations share some similarities to the overall structure of primary care consultations, there are two unique structures that occur in surgical consultations. These structures follow a logical progression of activities and are influenced by the type of visit (referred versus follow-up).
  
  
  CONCLUSIONS
  This article summarizes the first comprehensive description of the overall interactional structure of surgeon-patient consultations. It demonstrates that surgeon-patient consultations are structurally distinct from primary care consultations. This key finding has implications for surgeon-specific research and education, highlighting the need to question current assumptions in communication training and in clinical practice.
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia. sarah.white@mq.edu.au
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: White
authors.forename: Maria H
authors.initials: MH
authors.lastname: Stubbe
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Dew
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Macdonald
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Dowell
authors.forename: Rod
authors.initials: R
authors.lastname: Gardner
mesh_terms: D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand; D010358:Patient Participation; D010817:Physician-Patient Relations; D011182:Postoperative Care; D011300:Preoperative Care; D013043:Specialties, Surgical; D014705:Verbal Behavior; D014741:Video Recording