Reducing asymmetry in doctor-patient interaction: Patients' initiatives in specialised clinical encounters - Forme di riduzione dell'asimmetria nella comunicazione medico-paziente: Le iniziative dei pazienti nel corso di visite specialistiche

This study identifies a specific multimodal practice that patients use during medical encounters with a team of doctor in an Italian specialized centre for prosthesis construction and application. Focusing on the early stages of these encounters, the paper analyses the way in which patients delicately orchestrate their gaze, gesture and verbal behaviour to gain some extra speaking space, beyond that of mere respondents to doctors’ questions. By using Conversation Analysis, we show that patients produce this recurrent multimodal pattern, in methodically produced and recognizable ways. Patients manage to acquire the interactional role of “action initiators”; thus constraining doctors to respond: for instance, by producing unrequested information about their health status, by correcting implicit assumptions in the doctors’ questions, or by producing in dependent assessments. The paper contributes to previous research on patients’ agency and initiative, revising the notion of asymmetry in medical settings and highlighting the active role of the patient in every stage of these encounters.