When care meets commerce: Patient resistance in optometric consultations

We use conversation analysis to investigate clients' responses to treatment recommendations in optometric eye examinations (n = 66). As in other healthcare settings, in optometry, clients exercise their right to reject professionals' recommendations. In our analysis, it transpires that the reason for visit influences the emergence of rejections to recommendations: those who attend optometric examinations because they have noticed changes to their eyes/vision align with recommendations given by optometrists; those, however, who attend eye examinations on routine grounds resist recommendations. When resisting recommendations, clients provide accounts for their misalignment with the optometrist's recommendation. Through their accounts where these clients refer to their experience of using certain lenses, they display a consumer attitude to the consultation and treatment recommendation, both in terms of what accounts are put forward and the strength of patients' deontic stances. Our article, therefore, contributes to research concerned with patient centred care, as well as studies exploring the delivery of healthcare within a commercial context where patients are also consumers.