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Abstract Unlike micro-local studies on turn allocation, this study combines macro- and micro-local (Traverso, 2004) perspectives to explore turn allocation of the multi-participant medical-service-seeking 1 (MSS) party composed of the patient and his/her companion in accompanied medical consultations in China. Through both qualitative and quantitative analyses of the transcription of 20 audio recorded consultations in China, the talk distribution within the MSS party is examined in terms of the structural organization of a medical visit. Features of the talk distribution in different phases of the medical consultation and factors influencing turn allocation are explored. It is found that talk is not equally distributed within the MSS party, and all phases other than the opening and the closing witness a significant or marginally significant difference in talk contribution by the patient and the companion. Factors influencing turn allocation within the MSS party vary from phase to phase: epistemic gradient, sick-role-triggered activity transfer and coalition to offset power asymmetry are among the most important. The paper sheds light on the study of polylogue, enables cross-cultural comparisons of medical consultations, and has methodological implications for further studies of medical conversations. Highlights 1. Turn allocation in accompanied medical consultations operates at two levels: between parties and within a party. 2. The talk distribution within the treatment-seeking party between the patient and the companion varies from phase to phase. 3. The intra-party turn allocation is tacitly or overtly negotiated between the patient and the companion influenced by a range of factors, such as epistemic gradient, sick role-triggered activity transfer, and coalition to offset power asymmetry. [ABSTRACT FROM AUTHOR]