Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-23T09:34:00.700Z Has data issue: false hasContentIssue false
  • English
  • Français

Small talk, high stakes: Interactional disattentiveness in the context of prosocial doctor-patient interaction

Published online by Cambridge University Press:  16 October 2008

DOUGLAS W. MAYNARD  and
PAMELA L. HUDAK
DOUGLAS W. MAYNARD
Affiliation:
Department of Sociology, 1180 Observatory Drive, University of Wisconsin, Madison, Wisconsin 53706, maynard@ssc.wisc.edu
PAMELA L. HUDAK
Affiliation:
Department of Medicine, Saint Michael's Hospital, 30 Bond Street, Toronto, Ontario, CanadaM5B 1W8, hudakp@smh.toronto.on.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

The literature on “small talk” has not described the way in which this talk, even as it “oils the social wheels of work talk” (Holmes 2000), enables disattending to the instrumental tasks in which one or both participants may be engaged. Small talk in simultaneity can disattend to the movements, bodily invasions, and recording activities functional for the instrumental tasks of medicine. Small talk in sequence occurs in sensitive sequential environments. Surgeons may use small talk to focus away from psychosocial or other concerns of patients that may focus off the central complaint or treatment recommendation related to that complaint. Patients may use small talk to disattend to physician recommendations regarding disfavored therapies (such as exercise). Overall, small talk often may be used to ignore, mask, or efface certain kinds of agonistic relations in which doctor and patient are otherwise engaged. We explore implications of this research for the conversation analytic literature on doctor–patient interaction and the broader sociolinguistic literature on small talk.

Keywords

medicinedoctor–patient interactionconversation analysissmall talkcomplainingrecommending
Type
Research Article
Information
Language in Society , Volume 37 , Issue 5 , November 2008 , pp. 661 - 688
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Button, Graham, & Casey, Neil (1984). Generating topic: The use of topic initial elicitors. In Atkinson, J. Maxwell & Heritage, John (eds.), Structures of social action: Studies in conversation analysis, 167–90. Cambridge: Cambridge University Press.Google Scholar
Byrne, Patrick S., & Long, Barrie E. L. (1976). Doctors talking to patients: A study of the verbal behavior of general practitioners consulting in their surgeries. London: Her Majesty's Stationery Office.Google Scholar
Clift, Rebecca (1999). Irony in conversation. Language in Society 28:523–53.CrossRefGoogle Scholar
Coulmas, Florian (ed.) (1986). Direct and indirect speech. Berlin: Mouton de Gruyter.CrossRefGoogle Scholar
Coupland, Justine (2000). Introduction: Sociolinguistic perspectives on small talk. In Coupland, Justine (ed.), Small talk, 1–25. Edinburgh Gate, UK: Pearson Education.Google Scholar
Coupland, Justine; Coupland, Nikolas; & Robinson, Jeffrey D. (1992). “How are you?”: Negotiating phatic communion. Language in Society 21:207–30.CrossRefGoogle Scholar
Frankel, Richard M. (1983). The laying on of hands: Aspects of the organisation of gaze, touch and talk in the medical encounter. In Fisher, Sue & Todd, Alexandra D. (eds.), The social organization of doctor-patient communication, 19–54. Washington, DC: Center for Applied Linguistics.Google Scholar
Frankel, Richard M. (1995). Some answers about questions in clinical interviews. In Morris, G. H. & Chenail, R. J. (eds.), The talk of the clinic: Explorations in the analysis of medical and therapeutic discourse, 223–57. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Goffman, Erving (1963). Behavior in public places: Notes on the social organization of gatherings. New York: Free Press.Google Scholar
Goffman, Erving (1971). Relations in public: Microstudies of the public order. New York: Harper & Row.Google Scholar
Heath, Christian (1986). Body movement and speech in medical interaction. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Heath, Christian (2006). Body work: The collaborative production of the clinical object. In Heritage, John & Maynard, Douglas W. (eds.), Communication in medical care: Interaction between primary care physicians and patients, 185–213. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Heritage, John (1984). A change-of-state token and aspects of its sequential placement. In Atkinson, J. Maxwell & Heritage, John (eds.), Structures of social action, 299–345. Cambridge: Cambridge University Press.Google Scholar
Heritage, John (1998). Oh-prefaced responses to inquiry. Language in Society 27:291–334.CrossRefGoogle Scholar
Heritage, John, & Maynard, Douglas W. (2006). Introduction. In Heritage, John & Maynard, Douglas W. (eds.), Communication in medical care: Interaction between primary care physicians and patients, 1–21. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Heritage, John, & Sefi, Sue (1992). Dilemmas of advice: Aspects of the delivery and reception of advice in interactions between health visitors and first time mothers. In Drew, Paul & Heritage, John (eds.), Talk at work, 359–417. Cambridge: Cambridge University Press.Google Scholar
Heritage, John, & Stivers, Tanya (1999). Online commentary in acute medical visits: A method of shaping patient expectations. Social Science & Medicine 49:1501–17.CrossRefGoogle ScholarPubMed
Holmes, Janet (2000). Doing collegiality and keeping control at work. In Coupland, Justine (ed.), Small talk, 32–61. Edinburgh Gate, UK: Pearson Education.Google Scholar
Holt, Elizabeth (1996). Reporting on talk: The use of direct reported speech in conversation. Research on Language and Social Interaction 29:219–45.CrossRefGoogle Scholar
Hudak, Pamela L., & Maynard, Douglas W. (2007). Defining the domain of ‘topical small talk’ in clinical settings. Department of Medicine, St. Michael's Hospital. Toronto, Ontario, Canada.Google Scholar
Jefferson, Gail (1984a). On stepwise transition from talk about a trouble to inappropriately next-positioned matters. In Atkinson, J. Maxwell & Heritage, John (eds.), Structures of social action, 191–221. Cambridge: Cambridge University Press.Google Scholar
Jefferson, Gail (1984b). On the organization of laughter in talk about troubles. In Atkinson, J. Maxwell & Heritage, John (eds.), Structures of social action, 346–69. Cambridge: Cambridge University Press.Google Scholar
Jefferson, Gail (1990). List construction as a task and interactional resource. In Psathas, George (ed.), Interaction competence, 63–92. Washington, DC: International Institute for Ethnomethodology and Conversation Analysis and University Press of America.Google Scholar
Kinnell, Ann Marie K., & Maynard, Douglas W. (1996). The delivery and receipt of safer sex advice in pretest counseling sessions for hiv and aids. Journal of Contemporary Ethnography 24:405–37.CrossRefGoogle Scholar
Laver, John (1975). Communicative functions of phatic communion. In Kendon, A.Harris, R. M. & Key, M. R. (eds.), Organization of behavior in face-to-face interaction, 215–38. The Hague: Mouton.CrossRefGoogle Scholar
Malinowski, Bronislaw (1923). Supplement i: The problem of meaning in primitive languages. In Odgen, C. K. & Richards, I. A. (eds.), The meaning of meaning, 297–336. London: Routledge & Kegan Paul.Google Scholar
Mishler, Eliot (1984). The discourse of medicine: Dialectics of medical interviews. Norwood, NJ: Ablex.Google Scholar
Pomerantz, Anita (1978). Compliment responses: Notes on the co-operation of multiple constraints. In Schenkein, Jim (ed.), Studies in the organization of conversational interaction, 79–112. New York: Academic Press.CrossRefGoogle Scholar
Pomerantz, Anita (1984). Pursuing a response. In Atkinson, J. Maxwell & Heritage, John (eds.), Structures of social action, 152–64. Cambridge: Cambridge University Press.Google Scholar
Radcliffe-Brown, A. R. (1940). On joking relationships. Africa 13:195–210.CrossRefGoogle Scholar
Radcliffe-Brown, A. R. (1949). A further note on joking relationships. Africa 14:133–40.CrossRefGoogle Scholar
Ragan, Sandra L. (1990). Verbal play and multiple goals in the gynaecological exam interaction. Journal of Language and Social Psychology 9:67–84.CrossRefGoogle Scholar
Raymond, Geoff, & Lerner, Gene (2007). Sequence as a source of body behavior, body behavior as a resource for sequencing actions: The case of interjected actions. Paper delivered at the annual meetings of the American Sociological Association, New York.Google Scholar
Robinson, Jeffrey D. (2004). The sequential organization of ‘explicit’ apologies in naturally occurring english. Research on Language and Social Interaction 37:291–330.CrossRefGoogle Scholar
Schegloff, Emanuel A. (1986). The routine as achievement. Human Studies 9:111–51.CrossRefGoogle Scholar
Schegloff, Emanuel A. (2005). On complainability. Social Problems 52:449–76.CrossRefGoogle Scholar
Schegloff, Emanuel A., & Sacks, Harvey (1973). Opening up closings. Semiotica 8:289–327.CrossRefGoogle Scholar
Stivers, Tanya (2006). Treatment decisions: Negotiations between doctors and patients in acute care encounters. In Heritage, John & Maynard, Douglas W. (eds.), Communication in medical care: Interaction between primary are physicians and patients, 279–312. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Stoeckle, John D. (1995). Patients and their lives: Psychosocial and behavioral aspects. In Lipkin, J. MackPutnam, Samuel M. & Lazare, Aaron (eds.), The medical interview: Clinical care, education, and research, 147–52. New York: Springer.CrossRefGoogle Scholar
ten Have, Paul (1991). Talk and institution: A reconsideration of the ‘asymmetry’ of doctor-patient interaction. In Boden, Deirdre & Zimmerman, Don H. (eds.), Talk and social structure: Studies in ethnomethodology and conversation analysis, 128–63. Cambridge, UK: Polity Press.Google Scholar
ten Have, Paul (1999). Doing conversation analysis. London: Sage.Google Scholar