Why this clinic now? A context-sensitive aspect of accounting for visits
Why this clinic now? A context-sensitive aspect of accounting for visits
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为什么现在这个诊所？
DOI：
10.1016/j.socscimed.2020.113278
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发表时间：
2020
影响因子：
5.4
通讯作者：
T.
中科院分区：
文献类型：
--
作者：
Kushida;S.;Kawashima;M.;Abe;T.
在提出医疗咨询问题时，病人面临的任务是证明他们去看医生是合理的。先前的研究表明，患者通过将他们的问题描述为“可治疗”并将自己表现为合理的患者来建立他们就诊的合法性（Halkowski，2006; Heritage和罗宾逊，2006）。本研究通过分析日本“免费进入”制度下患者首次就诊的全科医学部门，探讨了这一合理性问题的上下文敏感方面。病人表现出他们的问题的方式，传达其相关性的特定医疗环境：他们的特点是他们的问题，适合相对较高水平的医疗护理或不容易落在其他专业。患者的问题与环境的相关性被视为规范性的，因为参与者采取措施来纠正问题与环境之间可能的不匹配。日本自由进入制度的体制安排是“说出来的”，作为通过参与者用来确定其访问合法性的做法进行协商的相关背景。
In presenting problems in medical consultations, patients face the task of justifying their visit to the doctor. Previous studies have shown that patients establish the legitimacy of their visit by characterizing their problem as “doctorable” and presenting themselves as reasonable patients (Halkowski, 2006; Heritage and Robinson, 2006). This study explores a context-sensitive aspect of this justification issue by analyzing patients' first visits to a department of general medicine under the Japanese “free access” system. Patients are shown to present their problem in a way that conveys its relevance to the particular medical setting: they characterize their problem as suitable for relatively high-level medical care or as not easily falling under other specialties. The patient's problem's relevance to the setting is treated as normative in that participants take measures to remedy the possible mismatch between the problem and the setting. The institutional arrangement of the Japanese free access system is “talked into being” as a relevant context for the consultations through the practices participants use to establish the legitimacy of their visits.