Verbal exchanges in medical interviews: concepts and measurement

Soc Sci Med. 1992 Aug;35(3):347-55. doi: 10.1016/0277-9536(92)90031-k.


The verbal exchange theory of medical interviews (consultations) proposes that patients and clinicians employ a joint repertoire of exchanges to accomplish their goals in the encounter. The skeleton of each exchange is a set of speech acts that tend to be used together in interviews, for example, (a) clinician questions and patient yes/no answers, or (b) clinician directives and patient agreements to comply. We describe seven principal exchanges, each of which has been identified empirically in multiple studies of interviews: Exposition, Closed Question, Checking, Direction, Inquiry, Explanation, and Instruction/Contracts.

Publication types

  • Review

MeSH terms

  • Humans
  • Medical History Taking*
  • Physical Examination / psychology
  • Physician-Patient Relations*
  • Sick Role
  • Verbal Behavior*