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Verbal exchanges in medical interviews: implications and innovations

S M Putnam1, W B Stiles

  • 1East Boston Neighborhood Health Center, MA 02128.

Social Science & Medicine (1982)
|June 1, 1993
PubMed
Summary

Medical interviews involve complementary patient and clinician speech exchanges. Understanding these seven exchanges (Exposition, Closed Question, Checking, Direction, Inquiry, Explanation, Instruction/Contracts) improves communication and relationships.

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Area of Science:

  • Medical Communication
  • Clinical Interviewing
  • Health Services Research

Background:

  • Medical interviews are crucial for patient care and involve complex verbal interactions.
  • Understanding the structure of these interactions is key to effective healthcare delivery.

Purpose of the Study:

  • To analyze the structure of verbal exchanges in medical interviews.
  • To explore how these exchanges facilitate or hinder patient and clinician goals.
  • To examine the role of these exchanges in clinical reasoning and relationship building.

Main Methods:

  • Analysis of verbal exchanges in medical consultations.
  • Identification and categorization of speech acts between patients and clinicians.
  • Examination of the relationship between exchange structure and interview outcomes.

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Main Results:

  • Medical interviews consist of seven principal, complementary verbal exchanges.
  • These exchanges, including Exposition, Closed Question, Checking, Direction, Inquiry, Explanation, and Instruction/Contracts, are jointly employed.
  • The structure of these exchanges impacts goal achievement, clinical reasoning, and relationship formation.

Conclusions:

  • The identified verbal exchange structure provides a framework for understanding medical interviews.
  • Optimizing these exchanges can enhance the effectiveness and humanistic quality of medical encounters.
  • Further research into novel exchanges may lead to improved patient-clinician communication.