Practices of Inclusion in Primary Care Visits of Unaccompanied Foreign Minors : Allocating Agency as an Interprofessionally Distributed Intercultural Competence

The presence of unaccompanied foreign minors (hereafter UFMs) is a challenge for the Italian welfare and foreigner reception systems. The chapter builds on an exploratory study on the ways in which professional educators interact with other professionals to manage UFMs’ access to care. In particular, it investigates triadic medical visits involving a general practitioner, an unaccompanied foreign minor, and his educator whose mandatory presence is aimed to support UFM patients throughout the encounter and make patient-physician communication as smooth as possible. Indeed, these institutional encounters constitute a perspicuous case to study how inclusion is performed (or not) through interprofessional interaction and the communicative resources whereby care professionals manage their often-incompatible goals and mandates. Adopting a Conversation Analysis-informed approach to a corpus of video-recorded visits, we describe the “pivot sequence”, a distributed discursive and multimodal practice whereby the educator(s) and the physician differently, but cooperatively manage the inclusion of the UFM as an active participant and intersubjectively overcome the “gathering information vs. allocating agency” dilemma typical of these institutional encounters. By enlightening the “interactive vigilance” of the educators (i.e., their capability to restore UFM’s agency whenever appropriate), we make a case for interprofessionally managed health care as a means to accomplish inclusion in interaction.