Conversation Analysis and Medicine

Abstract

Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to medical encounters. Attention is also given to promising new modes of research, and to the potential and challenges of improving medical practices by translating basic and rigorous empirical findings into innovative interventions for medical education. A case is made that increasing reliance on CA research can positively impact training and policies shaping the delivery of humane and quality medical care.

Patient-Initiated Pain Expressions: Interactional Asymmetries and Consequences for Cancer Care

“…A related problem involves how to provide reasonable grounds for offering pain reports that may or may not be solicited by doctors. When talk about pain does get initiated by patients, demonstrations of pain experiences and suffering are made available to doctors as medical authorities who may discount or directly avoid addressing patients' concerns (see Heath, 1989Heath, , 2002Heritage, 2005;Beach, 2015;Beach, Gutzmer, & Chapman, 2017). Assessing and responding to the topical relevance of volunteered information about pain and related topics has been shown to be a critical issue, particularly during moments when patients take diagnostic positions about their pain and doctors treat these contributions as encroaching on medical authority (Heath, 2002;McArthur, 2018).…”