Medicine: 'doctorability'

Question 1

Doctor-patient interaction

Answer 1

rights: entitlement. Freedom from personal responsibility from illness.

Obligations: being sick must be viewed as undesirable, no resignation. Must cooperate with docs

Question 2

Doctor appointment conversation order

Answer 2

Opening: doctor and patient establish interactional relationship

Presenting complaint: the patient presents the problem/reason for the visit

Examination: doctor conducts verbal or physical examination or both

Diagnosis: doctor (with patient) evaluates the patient’s condition

Treatment: doctor (in consultation with the patient), details treatment or further investigation

Closing: consultation terminated (often in the closing that the main point of the issue arises – “door knob symptoms”)

Question 3

Define disfluencies in medical interaction

Answer 3

Delicate issues – disfluency, stuttering, broken phrases

The same tools of conversation are used for institutional as well as mundane interaction

Question 4

Question formats designed to solicit ‘new’ concerns

Answer 4

• So what can I do for you today?

* How can I help?

Question 5

Question formats designed to solicit ‘follow up’ concerns

Answer 5

• How are you feeling these days?
• How are you feeling Joyce?
• Hi Mr. Anderson, how are you?

Question 6

Question formats for routine concerns

Answer 6

*Anything new?

Question 7

Define doctorability from patient’s perspective

Answer 7

the patient is accountable for their presence and must explain why they are asking for professional help

Often start with an account/story

Question 8

What are the three practises of doctorability

Answer 8

Diffuse responsibility

• “I asked my husband yesterday”

Show ‘troubles resistance’

• Laughter infiltration to lighten a serious conversation

Avoid diagnostic claims

• “I figured I should let you know”
• “I’m here on false pretences I think”