Talk on Cough: Symptom, Sign and Significance in Acute Primary Care
This chapter is a conversation analytic study of patients’ complaints about cough during general practice consultations, which is among the most common reasons for prescribing antibiotics. Many of these infections tend to be viral, and so the antibiotic prescriptions may be completely ineffective for the individual patient, but pose a great risk for public health. This chapter looks into cases where patients reiterate the cough complaints following a non-severe diagnosis. This reiteration could be heard as pressure for antibiotics. However, the study concludes that patients do not necessarily intend this, and that doctors can assure them without the offering of a prescription.
- Cals, J. W., Hood, K., Aaftink, N., Hopstaken, R. M., Francis, N. A., Dinant, G. J., & Butler, C. C. (2009). Predictors of patient-initiated reconsultation for lower respiratory tract infections in general practice. British Journal of General Practice, 59, 761–764. https://doi.org/10.3399/bjgp09X472656CrossRefGoogle Scholar
- Drew, P. (2006). Misalignments in“after-hours” calls to a British GP’s practice: A study in telephone medicine. Studies in Interactional Sociolinguistics, 20, 416.Google Scholar
- Heath, C. (1992). The delivery and reception of diagnosis in the general practice consultation. In P. Drew & J. Heritage (Eds.), Talk at work, interaction in institutional settings. Cambridge: Cambridge University Press.Google Scholar
- Heinemann, T., Lindström, A., & Steensig, J. (2011). Addressing epistemic incongruence in question–answer sequences through the use of epistemic adverbs. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 107–130). Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511921674.006CrossRefGoogle Scholar
- Heritage, J., & Maynard, D. W. (Eds.). (2006). Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press.Google Scholar
- Ijäs-Kallio, T., Ruusuvuori, J., & Peräkylä, A. (2011). Patient involvement in problem presentation and diagnosis delivery in primary care. Communication & Medicine, 7. https://doi.org/10.1558/cam.v7i2.131
- Mishler, E. G. (1984). The discourse of medicine: The dialectics of medical interviews. Norwood, NJ: Ablex. pp. Xii, n.d.Google Scholar
- Nielsen, S. B. (2015). “And how long have you been sick?”: The discursive construction of symptom duration during acute general practice visits and its implications for “doctorability.” Time & Society. https://doi.org/10.1177/0961463X15609808.
- Nielsen, S. B. (2018). Dealing with explicit patient demands for antibiotics in a clinical setting. In C. S. Jensen, S. B. Nielsen, & L. Fynbo (Eds.), Risking antimicrobial resistance (pp. 61–77). Cham, Switzerland: Palgrave Macmillan.Google Scholar
- Wigton, R. S., Darr, C. A., Corbett, K. K., Nickol, D. R., & Gonzales, R. (2008). How do community practitioners decide whether to prescribe antibiotics for acute respiratory tract infections? Journal of General Internal Medicine, 23, 1615–1620. https://doi.org/10.1007/s11606-008-0707-9CrossRefGoogle Scholar