In medical clinic visits, patients do more than convey information about their symptoms and problems so doctors can diagnose and treat them. Patients may also show how they have made sense of their health problems and may press doctors to interpret their problems in certain ways. Using conversation analysis, we analyse a practice patients use early in the medical visit to show that relatively benign or commonplace interpretations of their symptoms are implausible. In this practice, which we term pre-emptive resistance, patients raise candidate explanations for their symptoms and then report circumstances that undermine these explanations. By raising candidate explanations on their own and providing evidence against them, patients call for doctors to restrict the range of diagnostic hypotheses they might otherwise consider. However, the practice does not compel doctors to transparently indicate whether they will do so. Patients also display their ability to recognise and weigh the evidence for common, easily remedied causes of their symptoms. By presenting evidence against them, they show doctors the relevance of more serious diagnostic interpretations without pressing for them outright.

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A growing number of pharmacists practice within interdisciplinary health care teams, leading pharmacy educators to place increased emphasis on the development of interprofessional collaboration skills. In the pharmacist-physician relationship, pharmacists' medication therapy recommendations (MTRs) are a recurrent and significant interprofessional activity, one that can be challenging for both seasoned and student pharmacists. Drawing on in-depth ethnographic interviews with pharmacy preceptors and advanced student pharmacists, we identify and describe an important distinction between pharmacist-initiated MTRs and physician-initiated MTRs as contexts for interprofessional collaboration. We describe and illustrate a range of social, professional, and communication challenges that students experience in each context, as well as some strategies they use to navigate these challenges. Using the theoretical framework of dialectic tensions, we argue that the pharmacist-physician relationship is characterized by a tension between assertiveness and deference. We also offer recommendations to pharmacy preceptors, who can use this article to enhance the experiential education of pharmacists.

A key reason for the shortage of transplantable organs and tissue in the United States is the degree of resistance among the public to donating organs and tissue after death. In this article, we explore a single barrier to donation: the concern that medical personnel might provide "less-than-optimal" care to intended donors. Using 2 qualitative methodologies-analysis of family discussions about donation and analysis of in-depth interviews about donation-we explore what participants' discourse reveals about the variations and texture of this concern. The analysis revealed 4 aspects of this concern: (a) Participants expressed different versions of less-than-optimal care, each reflecting different assumptions about how medical personnel may approach the treatment of potential donors. (b) Participants expressed their concerns by describing hypothetical scenarios of medical treatment. These scenarios were designed to play up the plausibility of receiving less-than-optimal care and situated the speaker as the victim in the scenario. (c) Participants' uncertainty about the quality of medical treatment was sufficient grounds for not donating. (d) Participants expressed their concerns about medical treatment in terms of the perceived corruptibility of sociocultural institutions, including medical institutions. This analysis also revealed the lines of reasoning through which participants overcame a concern about receiving less-than-optimal-care. In our view, the most promising line of reasoning expressed by participants was to trust the legal and procedural protections built into the recovery process.

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