The Normativity of Medical Tests: Test Ordering as a Routine Activity in “New Problem” Consultations in Secondary Care

IF 3 1区文学 Q1 COMMUNICATION

Research on Language and Social Interaction Pub Date : 2020-08-14 DOI:10.1080/08351813.2020.1785768

Merran Toerien, C. Jackson, M. Reuber

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引用次数: 3

Abstract

ABSTRACT How does ordering a test fit into “new problem” medical consultations? Responding to calls for studies of the overall structural organization of consultations beyond primary care, this article depicts the organization of new problem consultations observed in two large neuroscience centers in the UK. This shows that—in addition to Robinson’s widely cited four main activities (establishing the reason for the visit, gathering information, delivering a diagnosis, recommending treatment)—test ordering is oriented to as an additional, normative activity. We show this numerically (tests were ordered in over 60% of our 65 new problem consultations) and by analyzing how participants orient to the activity of test ordering even when neurologists decide against testing. We argue that test ordering is a distinct activity, which, despite being treatment-oriented, displaces treatment in the here and now. Test ordering is thus consequential for progressivity, serving as both bridge and barrier to accomplishing the overarching medical project. Data are in British English.

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医学检查的规范性:二级医疗“新问题”咨询中的常规检查排序

订购检查如何适应“新问题”医学咨询?响应对咨询的整体结构组织超越初级保健的研究呼吁，这篇文章描述了在英国两个大型神经科学中心观察到的新问题咨询的组织。这表明，除了罗宾逊被广泛引用的四项主要活动(确定就诊原因、收集信息、提供诊断、推荐治疗)之外，测试排序也被视为一项额外的、规范的活动。我们用数字来证明这一点(在我们的65个新问题咨询中，超过60%的人安排了测试)，并通过分析参与者如何适应测试安排的活动，即使神经学家决定不进行测试。我们认为，测试排序是一种独特的活动，尽管是面向治疗的，但在此时此地取代了治疗。因此，测试顺序对进步性至关重要，既是完成总体医疗项目的桥梁，也是障碍。数据是英式英语。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research on Language and Social Interaction Multiple-

CiteScore

7.30

自引率

7.40%

发文量

期刊介绍： The journal publishes the highest quality empirical and theoretical research bearing on language as it is used in interaction. Researchers in communication, discourse analysis, conversation analysis, linguistic anthropology and ethnography are likely to be the most active contributors, but we welcome submission of articles from the broad range of interaction researchers. Published papers will normally involve the close analysis of naturally-occurring interaction. The journal is also open to theoretical essays, and to quantitative studies where these are tied closely to the results of naturalistic observation.