Chinese patients’ unsolicited presentation of primary concerns

Through an observation of naturally-occurring medical openings in China, we show that problem solicitation is not necessarily a routine practice in medical consultations. There are four common conversational slots in a Chinese medical opening allowing an unsolicited problem presentation, featuring a common deep structure – a generic pre-sequence followed by the specific base sequence of problem presentation. Three logically connected factors distinguishing Chinese medical openings from their Western counterparts are identified to provide the rationale for the normality of unsolicited problem presentation in China. The study enriches the understanding of culture-specificity in certain local structural organization of medical consultations, calls for activity-specific reconsideration of medical authority and reveals further resemblance between medical consultations and service encounters.