기능단계별로 나타난 의료면담의 제도 대화적 특징 연구

A Study of the Institutional Talk Characteristics of the Medical Interview in Terms of Functional Stages

  This study examines how asymmetry is produced in medical interviews as institutional interaction. In medical interaction, there are two primary asymmetries caused by status and power differences: the asymmetry of knowledge and the asymmetry of tasks between participants. For this research, dialogues between a doctor and his patients were investigated. In terms of analysis, this paper identifies five functional stages into which the procedures of a medical interview are arranged: opening, examination, diagnosis, prescription, and closing. As a result, two distinct exchanges were found: the question-answer sequence and the directive-response sequence. First, initiation of each sequence was conducted mainly by the doctor at each stage. A distinctive feature of the exchange was that the doctor"s questions at the introduction stage did not have any special purpose but were just an automatic courtesy greeting. The doctor"s initiations were usually followed by the patient"s response without any interruption. Second, the directive-response sequence was the most distinct phenomenon at the prescription stage. Two different forms of directives were used: warning and advising. The doctor"s directives had two functions. The first function was to maintain the doctor"s institutional authority and the second was to gain patient compliance with the doctor"s directives.