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Online commentary in acute medical visits: a method of shaping patient expectations

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  • Heritage, John
  • Stivers, Tanya

Abstract

This paper conceptualizes a type of physician communication, termed 'online commentary'. Online commentary is talk that describes what the physician is seeing, feeling or hearing during physical examination of the patient. Some dimensions of online commentary are described, and its functions in routine and acute medical consultations are distinguished. Using a case study method, the paper focuses on the role of online commentary in pre-empting patient resistance to upcoming 'no problem' diagnostic evaluations which could delegitimize patients' decisions to seek medical assistance, or deprive them of anticipated medical benefits. It is hypothesized that this role for online commentary may be associated with successful physician resistance to implicit or explicit patient demands for inappropriate antibiotic medication.

Suggested Citation

  • Heritage, John & Stivers, Tanya, 1999. "Online commentary in acute medical visits: a method of shaping patient expectations," Social Science & Medicine, Elsevier, vol. 49(11), pages 1501-1517, December.
    • Handle: RePEc:eee:socmed:v:49:y:1999:i:11:p:1501-1517
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    Cited by:

    1. Chatwin, John & Kennedy, Anne & Firth, Adam & Povey, Andrew & Rogers, Anne & Sanders, Caroline, 2014. "How potentially serious symptom changes are talked about and managed in COPD clinical review consultations: A micro-analysis," Social Science & Medicine, Elsevier, vol. 113(C), pages 120-136.
    2. Stivers, Tanya & Timmermans, Stefan, 2021. "Arriving at no: Patient pressure to prescribe antibiotics and physicians’ responses," Social Science & Medicine, Elsevier, vol. 290(C).
    3. Bridges, Susan & Drew, Paul & Zayts, Olga & McGrath, Colman & Yiu, Cynthia K.Y. & Wong, H.M. & Au, T.K.F., 2015. "Interpreter-mediated dentistry," Social Science & Medicine, Elsevier, vol. 132(C), pages 197-207.
    4. Broom, Alex & Broom, Jennifer & Kirby, Emma, 2014. "Cultures of resistance? A Bourdieusian analysis of doctors' antibiotic prescribing," Social Science & Medicine, Elsevier, vol. 110(C), pages 81-88.
    5. Turowetz, Jason, 2022. "Interaction order and the labeling of disorder: How parents mobilize personal knowledge in the clinic to resist medicalization of their children's behavior," Social Science & Medicine, Elsevier, vol. 294(C).
    6. Montenegro, Roberto E. & Dori-Hacohen, Gonen, 2020. "Morality in sugar talk: Presenting blood glucose levels in routine diabetes medical visits," Social Science & Medicine, Elsevier, vol. 253(C).
    7. Gibson, Mark & Neil Jenkings, K. & Wilson, Rob & Purves, Ian, 2006. "Verbal prescribing in general practice consultations," Social Science & Medicine, Elsevier, vol. 63(6), pages 1684-1698, September.
    8. Zhang, Xi & Wei, Xin & Zhang, Te & Tan, Yahe & Xu, Dongming & Ordóñez de Pablos, Patricia, 2023. "How platform-based internet hospital innovation affects doctors’ active stress coping efforts: The conservation of resource theory perspective," Technovation, Elsevier, vol. 121(C).
    9. Lindström, Anna K.B. & Tängdén, Thomas, 2022. "Introducing the C-reactive protein point-of-care test: A conversation analytic study of primary care consultations for respiratory tract infection," Social Science & Medicine, Elsevier, vol. 315(C).
    10. Stefanie Lopriore & Amanda LeCouteur & Katie Ekberg & Stuart Ekberg, 2019. "“You'll have to be my eyes and ears”: A conversation analytic study of physical examination on a health helpline," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(1-2), pages 330-339, January.
    11. White, Anne Elizabeth Clark, 2020. "When and how do surgeons initiate noticings of additional concerns?," Social Science & Medicine, Elsevier, vol. 244(C).
    12. Seale, Clive & Chaplin, Robert & Lelliott, Paul & Quirk, Alan, 2007. "Antipsychotic medication, sedation and mental clouding: An observational study of psychiatric consultations," Social Science & Medicine, Elsevier, vol. 65(4), pages 698-711, August.
    13. Maynard, Douglas W., 2006. ""Does it mean I'm gonna die?": On meaning assessment in the delivery of diagnostic news," Social Science & Medicine, Elsevier, vol. 62(8), pages 1902-1916, April.
    14. Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    15. Dooley, Jemima & Barnes, Dr Rebecca, 2022. "Negotiating ‘the problem’ in GP home visits to people with dementia," Social Science & Medicine, Elsevier, vol. 298(C).

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