Tacitly Accepted Treatment Recommendations in Secondary Care Visits

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 10. Healthcare Practices

Abstract

Understanding how treatment recommendations (TRs) are oriented to, talked about, and negotiated in doctor-patient interactions have long been a focus in primary care settings. In this analysis, a particular subset of secondary care visits will demonstrate that TRs in these instances are built throughout the visit and differ from primary care visits in which TRs are not provided until near the end of the patient visit. Unlike interactions seen in primary visits, in this data collection the TR is not the culminating point of the visit that all the activity phases have built up to—i.e., the problem presentation, the history taking, the physical examination, the diagnosis and then finally the TR before closing (Byrne and Long 1976). Instead, this paper will demonstrate how TRs in these secondary care visits are found near the beginning of the surgeon-patient interaction and proceed to be woven throughout the duration.
In these secondary visits, patients and surgeons are aligned in their stance that there is a singular treatment recommendation necessary to repair the patient’s condition. While there is room for negotiation over the logistics of the treatment recommendation, there is not room for maneuvering about the TR itself. A single-case analysis of a patient visit demonstrates how surgeons view patients as already having tacitly accepted the TR when patients scheduled their appointment. Because patients arrive already diagnosed and having tacitly accepted the treatment recommendation, the phrase structure seen in primary care visits do not apply to this subset of secondary care visit.

Author

• Anne White, University of California-Los Angeles