Article published in:
Interacting with Objects: Language, materiality, and social activity
Edited by Maurice Nevile, Pentti Haddington, Trine Heinemann and Mirka Rauniomaa
[Not in series 186] 2014
► pp. 79–98

“I’ll just see what you had before”

Making computer use relevant while patients present their problems

| University of Copenhagen
This chapter focuses on how doctors, during consultations, use computers as objects that serve diagnostic purposes. Specifically, the chapter investigates instances when doctors shift their attention towards their computers while patients present their problems. Such shifts momentarily change the focus of the doctor-patient interaction from patient-centred, in which patients typically describe their problems and/or answer questions from their own perspective, to computer-centred, where doctors seek answers about patients’ histories and general conditions as available in the digital records. I call this activity ‘historytaking side sequences’ because participants treat them as relevant departures from on-going interactional trajectories, which make a range of options such as diagnoses and informed decisions possible. The study sheds light on how computer use has become an integral part of face-to-face doctor-patient communication. More specifically, the study also shows that integrating the computer into the consultation requires doctors’ active efforts, both verbal and embodied, to indicate that the computer is a relevant object and its use is important for the medical business at hand.
Published online: 12 September 2014
https://doi.org/10.1075/z.186.04bec
References
Als, A.B.
(1997) The desk-top computer as a magic box: Patterns of behavior connected with the desk-top computer; GPs’ and patients’ perceptions. Family Practice, 14, 17–23. CrossrefGoogle Scholar
Beach, W.A.
(1995) Preserving and constraining options: “Okays” and “official” priorities in medical interviews. In G.H. Morris, & R.J. Cheneil (Eds.), The talk of the clinic: Explorations in the analysis of medical and therapeutic discourse (pp. 259–289). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Beck Nielsen, S.
(2011) Keeping the gate ajar during openings of general practice consultations. Communication & Medicine, 8, 235–245.Google Scholar
(2012) Patient initiated presentations of additional concerns. Discourse Studies, 14, 549–565. CrossrefGoogle Scholar
Boyd, E. & Heritage, J.
(2006) Taking the patient’s medical history: Questioning during comprehensive history-taking. In J. Heritage, & D.W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 151–184). Cambridge: Cambridge University Press. CrossrefGoogle Scholar
Byrne, P.S. & Long, B.E.L.
(1976) Doctors talking to patients: A study of the verbal behaviours of doctors in the consultation. London: HMSO.Google Scholar
Chan, W.-S., Stevenson, M., & McGlade, K.
(2008) Do general practitioners change how they use the computer during consultations with a significant psychological component? International Journal of Medical Informatics, 77, 534–538. CrossrefGoogle Scholar
Drew, P.
(2006) When documents ‘speak’: Documents, language and interaction. In P. Drew, G. Raymond, & D. Weinberg (Eds.), Talk and interaction in social research methods (pp. 63–80). London: Sage. CrossrefGoogle Scholar
Frankel, R.M.
(1995) Some answers about questions in clinical interviews. In G.H. Morris, & R.J. Cheneil (Eds.), The talk of the clinic: Explorations in the analysis of medical and therapeutic discourse (pp. 233–257). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Frankel, R., Altschuler, A., Sheba, G., Kinsman, J., Jimison, H., Robertson, N.R., & Hsu, J.
(2005) Effects of exam-room computing on clinician–patient communication: A longitudinal qualitative study. Journal of General Internal Medicine, 20, 677–682. CrossrefGoogle Scholar
Greatbatch, D.
(2006) Prescriptions and prescribing: coordinating talk- and text-based activities. In J. Heritage, & D.W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 313–339). Cambridge: Cambridge University Press. CrossrefGoogle Scholar
Greatbatch, D., Luff, P., Heath, C., & Campion, P.
(1993) Interpersonal communication and human-computer interaction: An examination of the use of computers in medical consultations. Interacting with Computers, 5, 193–216. CrossrefGoogle Scholar
Greatbatch, D., Heath, C., Campion, P., & Luff, P.
(1995) How do desk-top computers affect the doctor-patient interaction? Family Practice, 12, 32–36. CrossrefGoogle Scholar
Greatbatch, D., Heath, C., Luff, P., & Campion, P.
(1995) Conversation analysis: Human-computer interaction and the general practice consultation. In A. Monk, & N. Gilbert (Eds.), Perspectives on HCI: Diverse approaches (pp. 199–222). New York: Academic Press.Google Scholar
ten Have, P.
(1989) The consultation as a genre. In B. Torode (Eds.), Text and talk as social practice (pp. 115–135). Dordrecht/Providence, RI: Foris Publications.Google Scholar
(1991) A reconsideration of the “asymmetry” of doctor-patient interaction. In D. Boden, & D.H. Zimmerman (Eds.), Talk and social structure: Studies in ethnomethodology and conversation analysis (pp. 138–163). Cambridge: Polity Press.Google Scholar
Heath, C.
(1986) Body movement and speech in medical interaction. Cambridge: Cambridge University Press. CrossrefGoogle Scholar
(2006) Body work: The collaborative production of the clinical object. In J. Heritage, & D.W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 184–213). Cambridge: Cambridge University Press.Google Scholar
Heath, C., Hindmarsh, J., & Luff, P.
(2010) Video in qualitative research: Analysing social interaction in everyday life. London: Sage.Google Scholar
Heritage, J., & Maynard, D.W.
(2006) Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press. CrossrefGoogle Scholar
Hindmarsh, J., & Heath, C.
(2000) Sharing the tools of the trade: The interactional constitution of workplace objects. Journal of Contemporary Ethnography, 29, 523–562. CrossrefGoogle Scholar
Jefferson, G.
(1972) Side sequences. In D. Sudnow (Ed.), Studies in social interaction (pp. 294–338). New York: Free Press.Google Scholar
Kendon, A.
(1990) Conducting interaction: Patterns of behavior in focused encounters. Cambridge: Cambridge University Press.Google Scholar
Modaff, D.P.
(2003) Body movement in the transition from opening to task in doctor-patient interviews. In P. Glenn, C.D. LeBaron, & J. Mandelbaum (Eds.), Studies in language and social interaction: In honor of Robert Hopper (pp. 411–422). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Nevile, M.
(2007) Seeing the point: Attention and participation in the airline cockpit. In L. Mondada, & V. Markaki (Eds.), Interacting bodies: Online proceedings of the 2nd international conference of the International Society for Gesture Studies . Lyon: ENS LSH & ICAR Research Lab.Google Scholar
Noordman, J., Verhaak, P., van Beljouw, I., & van Dulmen, S.
(2010) Consulting room computers and their effect on general practitioner-patient communication. Family Practice, 27, 644–651. CrossrefGoogle Scholar
Pearce, C., Dwan, K., Arnold, M., Phillips, C., & Trumble, S.
(2009) Doctor, patient and computer – A framework for the new consultation. International Journal of Medical Informatics, 78, 32–38. CrossrefGoogle Scholar
Rhoades, D.R., McFarland, K.F., Holmes Finch, W., & Johnson, A.O.
(2001) Speaking and interruption during primary care office visits. Family Medicine, 33, 528–532.Google Scholar
Rhodes, P., Langdon, M., Rowley, E., Wright, J., & Small, N.
(2006) What does the use of a computerized checklist mean for patient-centered care? The example of a routine diabetes review. Qualitative Health Research, 16, 353–376. CrossrefGoogle Scholar
Rhodes, P., Small, N., Rowley, E., Langdon, M., Ariss, S., & Wright, J.
(2008) Electronic medical records in diabetes consultations: Participants’ gaze as an interactional resource. Qualitative Health Research, 18, 1247–1263. CrossrefGoogle Scholar
Riggins, S.H.
(1990) The power of things: The role of domestic objects in the presentation of self. In S.H. Riggins (Ed.), Beyond Goffman: Studies on communication, institution, and social interaction (pp. 341–367). Berlin: Mouton de Gruyter.Google Scholar
Robinson, J.D.
(1998) Getting down to business: Talk, gaze and body orientation during openings of doctor-patient consultations. Human Communication Research, 25, 97–123. CrossrefGoogle Scholar
(2001) Asymmetry in action: Sequential resources in the negotiation of a prescription request. Text, 21, 19–54.Google Scholar
(2003) An interactional structure of medical activities during acute visits and its implications for patients’ participation. Health Communication, 15, 27–59. CrossrefGoogle Scholar
(2006a) Soliciting patients’ presenting concerns. In J. Heritage, & D.W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 22–47). Cambridge: Cambridge University Press. CrossrefGoogle Scholar
(2006b) Nonverbal communication and physician-patient interaction: Review and new directions. In V. Manusov, & M.L. Patterson (Eds.), The Sage handbook of nonverbal communication (pp. 437–459). Thousand Oaks, CA: Sage. CrossrefGoogle Scholar
Robinson, J.D., & Heritage, J.
(2005) The structure of patients’ presenting concerns: The completion relevance of current symptoms. Social Science and Medicine, 61, 481–493. CrossrefGoogle Scholar
Robinson, J.D., & Stivers, T.
(2001) Achieving activity transitions in primary-care consultations: From history-taking to physical examination. Human Communication Research, 27, 253–298.Google Scholar
Schegloff, E.A.
(1998) Body torque. Social Research, 65, 535–596.Google Scholar
Stivers, T., & Heritage, J.
(2001) Breaking the sequential mold: Answering “more than the question” during comprehensive history-taking. Text, 21, 151–185.Google Scholar
Suchman, L.
(2007) Human-machine reconfigurations: Plans and situated actions. New York: Cambridge University Press.Google Scholar
Cited by

Cited by 2 other publications

Mondada, Lorenza & Kimmo Svinhufvud
2016. Writing-in-interaction. Language and Dialogue 6:1 ► pp. 1 ff. Crossref logo
Nielsen, Søren Beck
2016. How Doctors Manage Consulting Computer Records While Interacting With Patients. Research on Language and Social Interaction 49:1 ► pp. 58 ff. Crossref logo

This list is based on CrossRef data as of 27 january 2021. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers. Any errors therein should be reported to them.