 When patients demur: Resisting diagnostic closure in US primary careAmanda McArthur Social Science & Medicine, 2024, vol. 344, issue C Abstract: Patients are more engaged in their healthcare than ever before, including in the process of diagnostic sensemaking. But in acute primary care encounters, the interactional flow of the visit is shaped by an orientation toward the physician as the authority over diagnostic reasoning. Once physicians close diagnostic inquiry and transition into counseling, their assessment – and the extent to which it converges with the patient's perspective – comes into full view. Yet this is precisely when patients have reduced occasions to speak up if they do have concerns, as the “train has left the station” both diagnostically and interactionally. Using conversation analysis and a dataset of 75 video recordings of acute primary care encounters in the US, this article examines how patients speak up in this constrained environment. Keywords: Conversation analysis; Diagnosis; Resistance; Patient engagement; Medical authority; Primary care; United States (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:344:y:2024:i:c:s0277953624000637 Ordering information: This journal article can be ordered from DOI: 10.1016/j.socscimed.2024.116619 Access Statistics for this article Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian More articles in Social Science & Medicine from Elsevier |
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