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From the same journal

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

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Publication details

JournalQualitative Health Research
DateAccepted/In press - 18 Jan 2021
DateE-pub ahead of print - 4 Mar 2021
DatePublished (current) - 1 May 2021
Issue number6
Number of pages15
Pages (from-to)1129-1143
Early online date4/03/21
Original languageEnglish


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.

Bibliographical note

© The Author(s) 2021

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