Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners: The “One in a Million” Study

TY - JOUR

T1 - Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners

T2 - The “One in a Million” Study

AU - Lian, Olaug

AU - Nettleton, Sarah

AU - Wifstad, Age

AU - Dowrick, Christopher

N1 - © The Author(s) 2021

PY - 2021/5/1

Y1 - 2021/5/1

N2 - In this article, we qualitatively explore the manner and style in which medical encounters between patients and general practitioners (GPs) are mutually conducted, as exhibited in situ in 10 consultations sourced from the One in a Million: Primary Care Consultations Archive in England. Our main objectives are to identify interactional modes, to develop a classification of these modes, and to uncover how modes emerge and shift both within and between consultations. Deploying an interactional perspective and a thematic and narrative analysis of consultation transcripts, we identified five distinctive interactional modes: question and answer (Q&A) mode, lecture mode, probabilistic mode, competition mode, and narrative mode. Most modes are GP-led. Mode shifts within consultations generally map on to the chronology of the medical encounter. Patient-led narrative modes are initiated by patients themselves, which demonstrates agency. Our classification of modes derives from complete naturally occurring consultations, covering a wide range of symptoms, and may have general applicability.

AB - In this article, we qualitatively explore the manner and style in which medical encounters between patients and general practitioners (GPs) are mutually conducted, as exhibited in situ in 10 consultations sourced from the One in a Million: Primary Care Consultations Archive in England. Our main objectives are to identify interactional modes, to develop a classification of these modes, and to uncover how modes emerge and shift both within and between consultations. Deploying an interactional perspective and a thematic and narrative analysis of consultation transcripts, we identified five distinctive interactional modes: question and answer (Q&A) mode, lecture mode, probabilistic mode, competition mode, and narrative mode. Most modes are GP-led. Mode shifts within consultations generally map on to the chronology of the medical encounter. Patient-led narrative modes are initiated by patients themselves, which demonstrates agency. Our classification of modes derives from complete naturally occurring consultations, covering a wide range of symptoms, and may have general applicability.

U2 - 10.1177/1049732321993790

DO - 10.1177/1049732321993790

M3 - Article

SN - 1049-7323

VL - 31

SP - 1129

EP - 1143

JO - Qualitative Health Research

JF - Qualitative Health Research

IS - 6

ER -