Claiming Power in Doctor-Patient Talk

Nancy Ainsworth-Vaughn studied stories, topic control, "e;true"e; questions, and rhetorical questions in 101 medical encounters in US private-practice settings. In exceptionally lucid and accessible style, Ainsworth-Vaughn explains how power was claimed by and co-constructed for both patients and doctors (previous studies have focused upon doctors' power). The discourse varied along a continuum from interview-like talk to conversational talk. Six chapters are organized around data and include extended examples of actual talk in detailed transcription; four of these data-oriented chapters focus upon dynamic, moment-to-moment use of speech activities in emerging discourse, such as doctors' and patients' stories that co-constructed selves, and a patient's sexual rhetorical questions. Two more chapters offer non-statistical quantitative data on the frequency of questioning and sudden topic changes in relation to gender, diagnosis, and other factors. Contributing to discourse theory, Ainsworth-Vaughn significantly modifies previous definitions for topic transitions and rhetorical questions and discovers the role of storytelling in diagnosis. The final chapter provides implications for physicians and medical educators.

Nancy Ainsworth-Vaughn studied stories, topic control, "e;true"e; questions, and rhetorical questions in 101 medical encounters in US private-practice settings. In exceptionally lucid and accessible style, Ainsworth-Vaughn explains how power was claimed by and co-constructed for both patients and doctors (previous studies have focused upon doctors' power). The discourse varied along a continuum from interview-like talk to conversational talk. Six chapters are organized around data and include extended examples of actual talk in detailed transcription; four of these data-oriented chapters focus upon dynamic, moment-to-moment use of speech activities in emerging discourse, such as doctors' and patients' stories that co-constructed selves, and a patient's sexual rhetorical questions. Two more chapters offer non-statistical quantitative data on the frequency of questioning and sudden topic changes in relation to gender, diagnosis, and other factors. Contributing to discourse theory, Ainsworth-Vaughn significantly modifies previous definitions for topic transitions and rhetorical questions and discovers the role of storytelling in diagnosis. The final chapter provides implications for physicians and medical educators.