As doctors and patients communicate during medical interactions they both offer accounts and respond to them. By treating these accounts as interactional strategies which link social structure to social interaction we display how the medical interview is characterized by a moment-to-moment battle that mirrors and largely sustains the institutional authority and status of doctors and the reality of genders. (Medicine, communication, accounting practices, interactional strategies, institutional authority, professional status, gender)

This pa{)er simultaneously examines the relationship between noims as features of the social structure and norms as interactional accomplishments. Doctors as cultural members share a set of social facts about women as part of their common stock of knowledge. By posing these facts in a reflexive relationship with the interactional work participants do in spedfic settings we are able to display how doctors acting as 'secret apprentices' ferret cultural assumptions from medical interactions. A detailed comparison of two cases with the same doctor provide the data to examine the ways norms about patients qua women emerged and were negotiated against a background of cultural expectations or assumptions about women. This compadson reveals how divergent assumptions about women emerge, structure the discourse and influence the delivery of health care. Introductioii

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