Learning to talk and talking about talk - Medical Technologies and the Life World - page 35

Example 11
DOCTOR: I think it is important to fi nd some time for refl ection
if you don't feel comfortable then as a doctor you can always do
something else in the meantime [laughs]
you can take an EKG
or fake a phone call [laughs]
no but seriously
sometimes you have to take time out and think
'What the hell, I'll have to start all over again'
or at least start on a new track.
Another piece of advice given to the student is to develop and use
patient typologies. According to the supervisors, meeting each patient's
special communicative needs becomes easier when patients are classifi ed
and categorized. These categories can be based on the patient's social
characteristics, such as age, gender, and profession, or on his/her disease, or
his/her attitude towards health care, which includes the patient's expectations
of the encounter. Typologies offer simplifi cations that can serve as cognitive
support in future encounters and are sometimes provided by the GP or the
group supervisor or elaborated on during the discussion. One example of
categories used is young patients versus old patients.
Example 12
DOCTOR: Well a vigorous patient born in the 1920s doesn't visit a doctor
until he has multiple symptoms.
Do you see what I'm saying?
STUDENT: Isn't that very sound?
You only visit the doctor when
DOCTOR: Sound to visit a doctor!
But that's dangerous!
[laughs]
DOCTOR: Yeah I mean
People in the generation born in the 1920s when there weren't that
many doctors around generally don't visit the doctor once every three
months
so when they do, I interpret it as the person's really being worried.
Other recurrent categories are academically educated patients versus
uneducated patients, physically ill patients versus psychosomatically ill
patients or mentally ill patients, and acute versus chronically ill patients.
Some of the categories pertain to psychological characteristics, or have to
do with being a reserved or silent patient versus being a communicative and
talkative patient.