Subjective Illness Theories vs. Doctor Centred Conversation Techniques in Doctor-Patient Interaction

Introduction: In contemporary medicine doctor – patient interaction is being pushed into the background by instrumental diagnostics and medication. Doctor-patient talks tend to get reduced to less than five-minute-long task allocation sessions focusing on lab findings and instructions on the drugs prescribed. The present study is intended to analyse verbal exchange between family doctors and their patients suffering from chronic diseases and thus trying to find answers to the question how the interactional structure of doctor-patient talk makes it possible or impairs the interactive elaboration of patients’ lay illness theories and how these subjective lay illness theories influence the structure of the exchange.
Material and method: The study corpus includes an audio-taped conversation between family doctor and patient with hypertension. The transcription of the recording was carried out using transcribing computer software. The method of Conversation Analysis was used with special regard to turns, turn taking, the defence of the speaker’s role and simultaneous speech.
Results: The analysis of these interactive structural devices clearly demonstrates the superior role of the representative of the institution in the whole interaction.
Conclusions: In this communicative inequality subjective utterances become unimportant, which carries the risk that they will not get repeated later on in the conversation with the doctor. No effective therapeutic cooperation is possible without the awareness of subjective illness theories.

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