Abstract
This study identifies a specific multimodal practice that patients use during medical encounters with a team of doctor in an Italian specialized centre for prosthesis construction and application. Focusing on the early stages of these encounters, the paper analyses the way in which patients delicately orchestrate their gaze, gesture and verbal behaviour to gain some extra speaking space, beyond that of mere respondents to doctors’ questions. By using Conversation Analysis, we show that patients produce this recurrent multimodal pattern, in methodically produced and recognizable ways. Patients manage to acquire the interactional role of action initiators; thus constraining doctors to respond: for instance, by producing unrequested information about their health status, by correcting implicit assumptions in the doctors’ questions, or by producing independent assessments. The paper contributes to previous research on patients’ agency and initiative, revising the notion of asymmetry in medical settings and highlighting the active role of the patient in every stage of these encounters.
Highlights
The paper focuses upon patients’ initiatives during specialised medical encounters in an Italian centre for prosthesis construction and application
The analysis describes the way in which this multimodal pattern is constructed and how patients methodically and recurrently use it in this particular setting to gain conversational spaces besides and beyond just answering
Patients accomplish mitigation by showing that their assessments and assertions bear on objective facts that are accessible to doctors too. By displaying that they share access to the assessable with doctors −in other words, the limb is right there, accessible to doctors as well as to them− patients manage to elicit the doctors’ participation to the activity they have initiated. This aspect contributes to mitigate the initiative; patients display their being oriented to acknowledge the asymmetry of the setting and the doctors’ authority, they take an autonomous and independent initiative
Summary
The paper focuses upon patients’ initiatives during specialised medical encounters in an Italian centre for prosthesis construction and application. As patients are concerned, it has been demonstrated that they can adopt different types of behaviour in relation to the requirements of the questions, contrasting the asymmetry and gaining conversational opportunities by taking advantage of the answer space assigned to them. For instance, they can exploit their answering turn to introduce topics and issues which are not addressed in the doctors’ questions.
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