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Text & Talk

An Interdisciplinary Journal of Language, Discourse & Communication Studies

Ed. by Sarangi, Srikant

IMPACT FACTOR 2018: 0.400
5-year IMPACT FACTOR: 0.750

CiteScore 2018: 0.61

SCImago Journal Rank (SJR) 2018: 0.305
Source Normalized Impact per Paper (SNIP) 2018: 0.670

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Volume 21, Issue 1-2


Missing assessments: Lay and professional orientations in medical interviews

Charlotte M Jones
Published Online: 2008-06-02 | DOI: https://doi.org/10.1515/text.1.21.1-2.113


This study extends conversation analytic research by Frankel and colleagues on the occurrence (or nonoccurrence) of assessments in physician–patient interviews. As assessments are regularly offered after hearing news or information just asked for in everyday talk (often displaying alignment and as liation for the news bearer), and as reportings commonly occur in both mundane and medical interaction, the post-question–answer slot (after newsworthy answers) was identified as one interactional environment to investigate. Analysis revealed that lay and professional orientations do not mesh. At these points, assessments are absent, unlike in everyday talk. Instead, physicians offer (a) no response, or (b) an acknowledgment token. Patients subsequently exhibit, through pausing and withholding speaking, that they expect a different type of response from physicians. Hence, gaps occur when assessments might be due (from a mundane perspective), marking them as missing. After these gaps, the participants react differently. Physicians disattend the lack of assessments, instead continuing with ‘business at usual’. Patients display an orientation to the absence, using various strategies ‘unsuccessfully’. Implications are discussed in relationship to as liation and social support, important in the delivery of health care. Several explanations for absent assessments in medical interviews are also explored.

Keywords: medical interviews; physician-patient communication; assessments; social support; conversation analysis

About the article

Charlotte M Jones

Associate Professor of Communication Studies at Carroll College. Her research focuses on the study of medically related interaction including provider–patient interviews, family therapy encounters, and support group meetings. Other areas of interest are the communication of social support and sensitivity in everyday and institutional settings.

Published Online: 2008-06-02

Published in Print: 2001-06-12

Citation Information: Text – Interdisciplinary Journal for the Study of Discourse, Volume 21, Issue 1-2, Pages 113–150, ISSN (Online) 1613-4117, ISSN (Print) 0165-4888, DOI: https://doi.org/10.1515/text.1.21.1-2.113.

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