Breaking the sequential mold: Answering 'more than the question' during comprehensive history taking

Abstract

This article uses conversation analysis focusing largely on a single unremarkable primary care doctor-patient encounter. In the relatively restrictive context of comprehensive medical history taking, this article investigates some of the ways in which a patient expands her answers- volunteering more information than was asked for. This article draws on previous work to establish that comprehensive history taking is designedly a restrictive environment for patients' responses, and is oriented to by patients as such. In this context, patient expansions are accountable in various ways, and are built to implement specific projects. We review a range of examples of these expansions, and examine their design and import for the interaction. The implication of this research is that while doctors may not routinely affiliate with patients' lifeworld narratives as interactants in ordinary conversation might, these narratives can nonetheless be treated as resources for learning more about patients and ultimately facilitating their care and education. © Walter de Gruyter.