Narrative co-construction in the medical consultation: How agency and control affect the diagnosis

Authors

  • Caroline H. Vickers California State University, San Bernardino
  • Ryan Goble California State University, San Bernardino
  • Christopher Lindfelt California State University, San Bernardino

DOI:

https://doi.org/10.1558/cam.v9i2.159

Keywords:

co-construction, interaction, medical discourse, multilingual, narrative

Abstract

The purpose of this paper is to examine patient-provider narrative co-construction of symptoms, diagnosis and treatment in the medical consultation. Narrative scholarship has demonstrated that conversational narratives, including those that take place in medical consultations, are typically co-constructed by all participants within the conversation. In the context of the medical consultation, this means that patient narratives are co-constructed with providers, and that at times, provider contributions to the patient narrative can hide patient contributions. The inherent power asymmetry that exists between patient and provider facilitates the possibility for provider contributions to obscure those of the patient. Based on audio-recorded data from medical consultations between two different nurse practitioners and one patient, findings from this study demonstrate that such narrative co-construction leads to differential information regarding the patient’s symptoms, diagnosis and treatment. Implications include the need for providers to relinquish control over to the patient to allow the patient to fully articulate narrative accounts of their medical issues.

Author Biographies

Caroline H. Vickers, California State University, San Bernardino

Caroline H. Vickers is Associate Professor of Linguistics in the English Department at California State University, San Bernardino, USA. Her research interests include discourse analysis, health disparities, language and identity, and medical discourse.

Ryan Goble, California State University, San Bernardino

Ryan Goble is a student in the Applied Linguistics/Teaching English as a Second Language track of the MA Program in English Composition at California State University, San Bernardino, USA. His research interests include sociolinguistics and linguistic approaches to health research.

Christopher Lindfelt, California State University, San Bernardino

Christopher Lindfelt is Assistant Professor of Healthcare Management and Health Services Administration at California State University, San Bernardino, USA. His research interests primarily focused on health disparities, brain health, the ageing population, as well as current trends in long-term care.

Published

2013-05-20

How to Cite

Vickers, C. H., Goble, R., & Lindfelt, C. (2013). Narrative co-construction in the medical consultation: How agency and control affect the diagnosis. Communication and Medicine, 9(2), 159–171. https://doi.org/10.1558/cam.v9i2.159

Issue

Section

Articles