“The oncologist told me”: Reported speech as a patients’ resource to volunteer concerns in oncological visits

Abstract

Based on the “patient centered approach”, growing emphasis within policies has been put on patients' active participation in medical encounters. Consistently, research has investigated patients' initiatives during medical visits in a wide array of settings and specialties. Among these, oncological care constitutes a setting where patient participation is particularly crucial as well as challenging. However, previous studies in this setting have focused mainly on doctors' interactional work, with few works exploring patients' expressions of fears, uncertainties, and hopes. The present study contributes to this underexplored line of inquiry by showing how oncological patients take the initiative and make relevant their concerns through reported speech (RS). Based on a corpus of 106 video-recorded oncological visits collected in Italy and adopting conversation analysis, the article shows how patients use RS to volunteer some information they have previously been told by other, non-present physicians. Through RS, patients cautiously make relevant specific aspects of their case that have not been addressed in the ongoing interaction and appear to constitute a concern for them (e.g., presence of metastases, treatment side effects, hospitalization length). In response, the physician addresses the patient's concern, either by confirming the reported information or by distancing themselves from it, thus providing their opinion on the matter.