Symptom assessment and patient resistance in primary care interactions in Chinese hospitals
Keywords:conversation analysis, pragmatics of description, chinese primary care, diagnosis, resistance
In a study of primary care consultations in Chinese western-style medicine, two recurrent interactional patterns have been identified which are associated with making medical assessments. At various points in a consultation, the clinician may indicate that the patient’s symptoms are ‘normal’ and that nothing is medically concerning or problematic. The patient may resist that by representing her condition as being in some fashion abnormal. By contrast, when the clinician considers the patient’s symptoms as abnormal, i.e. indicating a medical abnormality and worthy of medical care (i.e. doctorable), the patient may resist by normalising her symptoms. Through analysing doctors’ symptomatic accounts and patients’ resisting talk, ‘symptom abnormality’ emerges as the central form of expression at moments in which doctors and patients are misaligned in their diagnostic reasoning.
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