The structure of patients' presenting concerns: the completion relevance of current symptoms

Soc Sci Med. 2005 Jul;61(2):481-93. doi: 10.1016/j.socscimed.2004.12.004.


This article uses conversation analysis to investigate the problem-presentation phase of 302 visits between primary-care physicians and patients with acute problems. It analyzes the social-interactional organization of problem presentation, focusing on how participants recognize and negotiate its completion. It argues that physicians and patients mutually orient to the presentation of current symptoms--that is, concrete symptoms presented as somehow being experienced in the here-and-now--as a locus of transition between the patient-controlled problem-presentation phase of the visit and the physician-controlled information-gathering phase. This is a resource for physicians to distinguish between complete and incomplete presentations, and for patients to manipulate this distinction.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Communication*
  • Diagnosis, Differential
  • Humans
  • Office Visits
  • Patient Participation*
  • Physician-Patient Relations*
  • United States
  • Videotape Recording