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Objective: This paper examines a previously neglected phenomenon in doctor-patient interaction studies, i.e. the achievement of mutual disengagement-a specific state of coordination, in which participants suspend reciprocal gaze and turn into separate axes of involvement. In the specialized setting of the oncology visit, which we consider in this study, mutual disengagement is linked to important tasks that the oncologist has to carry out, notably the scrutiny of the histological exam during the diagnostic assessment phase.Methods: Our data corpus includes 56 video-recorded oncology visits. We employ conversation analysis to discern how mutual disengagement is achieved, sustained and ended.Results: Our analysis shows that suspension of mutual engagement is a joint accomplishment that requires intersubjective cooperation. It also reveals that when talk and reciprocal engagement are suspended, intersubjective alignment is more vulnerable to breakdown.Conclusion: Our findings eschew a characterization of the oncologist as solo arbiter of the interactional exchange. An alignment with the patient is key to the felicitous accomplishment of the visit. We also suggest that a successful medical encounter is not only characterized by harmonious verbal communication, between doctor and patient, but also by felicitous pauses in their joint engagement.Practice Implications: In building a room of one's own, the oncologist has the responsibility to co-construct with the patient an experience of interactional attunement and mutual understanding. [ABSTRACT FROM AUTHOR]

Abstract In this paper we examine how doctor and patient coordinate actions in interaction towards the smooth accomplishment of the medical visit. Such coordination entails primarily the management of time and praxis, i.e. the apportionment of time to the tasks to be completed during the visit; and it is not an easy enterprise, for a number of reasons: 1) the tasks to be carried out during the visit are not familiar in equal measure to doctor and patient; 2) the extent of attention to be devoted to each task cannot be fully determined in advance but requires ongoing judgment and calibration; 3) generally, the timeframe of the visit is relatively limited. Our ethnographic and conversation analytic study of oncological visits shows that doctor and patient rely on a range of semiotic resources to achieve mutual understanding and coordinated actions. In particular, our analysis has identified textual artifacts and metapragmatic utterances as key semiotic components in the coordination and negotiation of the temporal trajectories and courses of actions that constitute and traverse the oncology visit. Highlights • The structuring of time and activity in oncology visits was studied. • Ethnographic observation and conversation analysis of videorecordings were carried out. • The structuring of time and activity is a joint accomplishment by doctor and patient. • Textual artifacts and metapragmatic utterances are the key semiotic resources used. • Effective management of visits' timing may be more beneficial than having more time. [ABSTRACT FROM AUTHOR]