Diagnostic interaction: The patient as a source of knowledge?

Abstract

OBJECTIVE: To explore diagnostic interaction to understand more about why some problems appear medically unexplained. DESIGN: A qualitative discourse analysis case study. SETTING: Encounters between women patients and general practitioners in primary healthcare. SUBJECTS: Microanalysis of two audiotaped consultations without a clear-cut diagnosis and opposing levels of mutuality between doctor and patient. MAIN OUTCOME MEASURES: Descriptions of linguistic patterns in diagnostic interaction. RESULTS: Two patterns were identified demonstrating how different ways of speech acts contribute or obstruct diagnostic interaction and common ground for understanding. To invite or reject the patient into/from the diagnostic process, and to recognize or stereotype the patient may impose on how illness stories are perceived as medically unexplained. CONCLUSION: Making sense of illness can be enhanced by inviting and recognizing the patient's story.