The normativity of medical tests: Test ordering as a routine activity in ‘new problem’ consultations in secondary care

TY - JOUR

T1 - The normativity of medical tests

T2 - Test ordering as a routine activity in ‘new problem’ consultations in secondary care

AU - Toerien, Merran Gurney

AU - Jackson, Clare

AU - Reuber, Markus

N1 - © 2020 Crown Copyright.

PY - 2020

Y1 - 2020

N2 - How does ordering a test fit into new-problem medical consultations? Robinson (2003) has shown that there are four main activities in new problem consultations in primary care (establishing the reason for the visit, gathering information, delivering a diagnosis, recommending treatment), but he speculates that other types of medical consultation may be organised differently. We show a key difference in new problem consultations in secondary care (neurology): clinicians and patients orient to test ordering as a normative activity. Our data come from 65 new problem consultations in two large neuroscience centres in the UK, in which tests were routinely ordered or, if not, their relevance was nonetheless handled by both parties. We argue that test ordering, despite being treatment-oriented, displaces treatment in the here-and-now. It thus serves as both bridge and barrier to accomplishing the overarching medical project. Data are in British English.

AB - How does ordering a test fit into new-problem medical consultations? Robinson (2003) has shown that there are four main activities in new problem consultations in primary care (establishing the reason for the visit, gathering information, delivering a diagnosis, recommending treatment), but he speculates that other types of medical consultation may be organised differently. We show a key difference in new problem consultations in secondary care (neurology): clinicians and patients orient to test ordering as a normative activity. Our data come from 65 new problem consultations in two large neuroscience centres in the UK, in which tests were routinely ordered or, if not, their relevance was nonetheless handled by both parties. We argue that test ordering, despite being treatment-oriented, displaces treatment in the here-and-now. It thus serves as both bridge and barrier to accomplishing the overarching medical project. Data are in British English.

U2 - 10.1080/08351813.2020.1785768

DO - 10.1080/08351813.2020.1785768

M3 - Article

SN - 0835-1813

VL - 53

SP - 405

EP - 424

JO - Research on Language and Social Interaction

JF - Research on Language and Social Interaction

IS - 4

ER -