Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners: The “One in a Million” Study

Lian, OS ORCID: 0000-0002-5752-1486, Nettleton, S, Wifstad, Å and Dowrick, C ORCID: 0000-0002-4245-2203 (2021) Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners: The “One in a Million” Study Qualitative Health Research, 31 (6). pp. 1129-1143. ISSN 1049-7323, 1552-7557

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Abstract

In this article, we qualitatively explore the manner and style in which medical encounters between patients and general practitioners (GPs) are mutually conducted, as exhibited in situ in 10 consultations sourced from the One in a Million: Primary Care Consultations Archive in England. Our main objectives are to identify interactional modes, to develop a classification of these modes, and to uncover how modes emerge and shift both within and between consultations. Deploying an interactional perspective and a thematic and narrative analysis of consultation transcripts, we identified five distinctive interactional modes: question and answer (Q&A) mode, lecture mode, probabilistic mode, competition mode, and narrative mode. Most modes are GP-led. Mode shifts within consultations generally map on to the chronology of the medical encounter. Patient-led narrative modes are initiated by patients themselves, which demonstrates agency. Our classification of modes derives from complete naturally occurring consultations, covering a wide range of symptoms, and may have general applicability.

Item Type:	Article
Uncontrolled Keywords:	Humans, Physician-Patient Relations, Referral and Consultation, Primary Health Care, England, General Practitioners
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health
Depositing User:	Symplectic Admin
Date Deposited:	20 Jul 2021 09:36
Last Modified:	24 Jan 2026 02:54
DOI:	10.1177/1049732321993790
Open Access URL:	https://doi.org/10.1177%2F1049732321993790
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3130693
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