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Conversation Analysis

4. CA and the Medical Encounter

Turn Design in History Taking

Physician questions are likewise replete with differences in levels and types of presupposition – compare "What kind of contraception do you use?" with "Are you using any contraceptives?" They also vary in terms of whether questions are tilted, for example to promote positive medico-social outcomes in sequences of 'optimized' questioning (Boyd and Heritage, 2006).

Example 6

In the following case the patient presented with upper respiratory symptoms:

Or whether, conversely, they anticipate the confirmation of adverse medical signs in sequences of questions which (Stivers, 2007) labels 'problem attentive' as in the following case in which the patient presented with flu symptoms:

In contrast to the previous example, each of these questions is geared towards an affirmative, and problematic, response and is sensitive to the symptoms with which the child presented.

Boyd E., Heritage J. (2006). Taking the history: Questioning during comprehensive history Taking. In:  Heritage J., Maynard D., Ed,  Communication in Medical Care: Interactions between Primary Care Physicians and Patients. Cambridge, UK: Cambridge Unive
Stivers, T. (2007). Prescribing under pressure: Parent-physician conversations and antibiotics. New York: Oxford University Press.