Treatment Recommendations as Actions

• In Event: 101 - Regular Session. Conversation Analysis

Abstract

From the earliest studies of doctor-patient interaction (Byrne & Long, 1976), it has been recognized that treatment recommendations may be expressed in more or less authoritative ways, based on their design and delivery. There are clear differences between I'm going to start you on X, We can give you X to try; and Would you like me to give you X. Yet little is known about this variation, its contexts, or its consequences. In this paper, we develop a basic taxonomy of treatment recommendations in primary care as a first step towards a more comprehensive investigation. We take as our point of departure the observation that treatment recommendations such as those above not only represent different formulations, they represent different social actions. We distinguish five main treatment recommendation actions: pronouncements, suggestions, proposals, offers and assertions. We ask what the main dimensions on which these recommendations vary are and to what end? And what sorts of factors shape a clinician's use of one action type over another with respect to recommending a medication in the primary care context?

Authors

• Tanya Stivers, UCLA

• John Heritage, UCLA

• Rebecca Barnes, University of Nottingham

• Rose McCabe, University of Essex

• Laura Thompson, Loughborough University

• Merran Gurney Toerien, University of York