Epistemics, Entitlement, and Counting in Primary Care Interaction

• In Event: 146 - Regular Session. Asymmetries in Medical Care: Using Conversation Analysis to Understand the Practice of Medicine

Abstract

Counting how long a patient has had a particular problem, and calculating rates of occurrences of the patients’ problems, are routine occurrences in primary care interaction. Yet the various methods of counting employed by doctors and patients has received relatively little attention. In this preliminary analysis we will consider some of the various ways that patients and doctors are entitled (or licensed) to count health related phenomena.

Counting, and rendering proper, legitimate counts, is deeply bound up with issues of epistemics and the entitlement or license to do a proper count. Therefore, investigations into counting practices in primary care (and other realms of activity) are always also investigations into epistemic rights and responsibilities as achievements.

In this preliminary analysis we will focus on: how doctors treat the patient’s count as appropriate and/or adequate; how doctors and patients treat the phenomenon as legitimately ‘not countable’, or ‘not needing to be counted’; and, how doctor’s display doubt regarding the patient’s count (thereby also displaying doubt about the license or entitlement of the patient to do this count properly).

In considering these cases, we will be able to understand at a deeper level how various are the ways that the world of health phenomena are rendered ‘countable’ by doctors and patients. We will also be able to better understand how doctors and patients work to jointly achieve the countability, (and sometimes, the ’uncountability’) of health phenomena.

Author

• Timothy Halkowski, University of Wisconsin-Stevens Point