Physicians' Interruptions In Clinical Interviews: A Conversation Analytic Approach

Physicians have been confronted with the accusation that they concentrate on thebiomedical diseases, regardless of the bio-psychological model of diseases in clinicalinterviews. A vast number of complaints are concerned with inefficientcommunication between patients and physicians, some of which can be contributed tophysicians' poor language skills. On the other hand, verbal communication serves asthe primary means for physicians to draw a conclusive diagnosis and aids to counselan appropriate treatment plan, with the facility of medical tests and mechanicalexaminations in hospital. From various communicative phenomena, interruption, acommon occurrence in physician-patient talking in clinical interviews, is singled outto be investigated into in this study.The present study took the conversational analytic approach to analyze the datacollected from five best-known hospitals in Changchun, China, and discussedinterruptions initiated by physicians from three aspects. First, occurrences ofinterruptions are correlated with stages of medical interviews. In complaint,physicians interrupt to manipulate the flow of medical procedure;and in diagnosisand treatment stages, interruptions occur more when physicians believe their authoritymeet with challenges. Second, physicians' interruptions can be either cooperative ordisruptive, with four subcategories respectively. Cooperative interruptions are moreadvisable, for they can help build rapport, enhance solidarity and secure trust;disruptive ones, however, exert negative influence on physician-patient relationship.Hence, the third aspect of this discussion focuses on the strategies to convertdisruptive interruptions into cooperative ones, in form especially, including locating aproper cut-in place, using soothers and choosing the right wording.This is a relatively comprehensive research of physicians' interruption:contextual factors, categorizations and strategies were studied in order to enhance amore balanced understanding of this conversational phenomenon, to clear up one ofthe barriers in physician-patient communication, thereby, to achieve a harmoniousrelationship that can improve the effectiveness of communication and medicaltreatment.