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Christopher Pearce1, Stephen Trumble, Michael Arnold

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Area of Science:

  • Medical Sociology
  • Human-Computer Interaction
  • General Practice

Background:

  • Computers are increasingly integrated into general practice consultations globally.
  • Existing literature explores the computer's impact on the doctor-patient relationship.
  • Patient-centeredness highlights the relationship's importance for outcomes, now complicated by the computer's presence.

Purpose of the Study:

  • To characterize the patient-doctor-computer relationship during the initial phase of medical consultations.
  • To analyze the interaction dynamics introduced by computer use in primary care settings.

Main Methods:

  • Utilized digital video to record 141 general practitioner (GP) consultations.
  • Employed Goffman's dramaturgical methodology for analyzing observed consultation behaviors.
  • Involved 20 GPs in the direct observation study.

Main Results:

  • Consultation openings were categorized as 'doctor,' 'patient,' or 'computer' openings, based on the primary source of influence.
  • Identified specific interactional behaviors within each of these three opening categories.
  • Demonstrated that the computer's presence significantly influences the initiation of the consultation.

Conclusions:

  • The introduction of computers has fundamentally changed the structure of consultation openings.
  • Consultations now involve three interacting participants (doctor, patient, computer), unlike the previous two-person dynamic.
  • Future research must consider the computer's role in shaping consultation flow and information exchange among all parties.