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We investigated general practitioners’ (GPs’) responses to patients’ concerns in chronic care consultations. Video recordings of 14 consultations were analyzed with conversation analysis. We found two categories of responses: exiting and exploring the patient’s concerns. Most GPs exited the concern by interrupting the patient, acknowledging the concern but then referring back to the progression of the consultation, or affiliating with the concern without exploring it. Only a few raised concerns were explored, and then most often the somatic rather than the emotional aspects of them. The findings point to the risk of missing patients’ voiced concerns in consultations with a fixed agenda.

Patientology traditionally signifies the scientific study of the patients through medical sociological and anthropological perspectives. The last decades have witnessed notable changes in the understanding of what it means to be a patient and what role patients play in healthcare processes, with the rise of concepts such as patient-centered care, patient empowerment, and patient participation. This article develops a reconceptualization of patientology, proposes a model hereof, and exemplifies its use through the application to an illustrative case. Our reconceptualization of patientology considers the patient as the central actor in a network of healthcare actors. Being a patient requires health capital that is comprised of health-relevant aspects of Bourdieusian forms of capitals: economic, social, and cultural capital. The patient role is constructed through the patient’s interaction with a range of healthcare actors such as health professionals, relatives, and other patients. The proposed model allows for understanding health inequalities as based on differences in (cultural) health capital, opening up new avenues of investigating and ameliorating patients’ challenges in health interactions. The model allows for a fresh take on the reciprocity of Parsons social sick role, allowing to clarify both how patients can contribute to their own health and healthcare and where and how health professionals ought to meet their patients.

As antibiotic resistance becomes a growing health emergency, effective strategies are needed to reduce inappropriate antibiotic use. In this article, one such strategy – communicative practices associated with the C-reactive protein point-of care test – is investigated. Building on a collection of 31 videorecorded consultations from Danish primary care, and using conversation analysis, this study finds that the rapid test can be used throughout the consultation to incrementally build the case for a nonantibiotic treatment recommendation, both when the test result is forecast and reported. The study also finds that the format of reports of elevated results differs from that of ‘normal’ results, resulting in a subtle shift of authority from doctor to test.

Antibiotic overuse and resulting antibiotic resistant bacteria are a growing problem both nationally and globally (ECDC 2014). Primary care physicians prescribe 90% of the antibiotics used for humans in Denmark, and 2/3 of these are prescribed for upper respiratory tract infection (Bjerrum et al. 2014). However, many of these prescriptions are unnecessary and excessive. The reasons for overprescription of antibiotics are many, but this article focuses only on one: the importance of language for the treatment recommendation and its acceptance or rejection. Looking at a single Danish doctor-patient conversation which moves successfully from a recommendation for antibiotics to a recommendation for non-antibiotic nasal spray, it is suggested that the format of the treatment recommendation may influence patient willingness to bypass antibiotics. Using Conversation Analysis, the two treatment recommendations (one for antibiotics and a subsequent one for nasal spray) are analyzed in detail, and the reasons for the acceptance of the second one over the first one are discussed. Designing the treatment recommendation as an option which the patient is given agency to choose is suggested as a possible way to reverse or avoid antibiotic prescription in cases where it is medically safe.

Overforbrug af antibiotika og medfølgende antibiotisk resistens er et voksende problem både nationalt og globalt (EDCD 2014). Primærsektoren står for 90% af den antibiotika, der gives til mennesker i Danmark, og 2/3 heraf udskrives for øvre luftvejsinfektioner (Bjerrum m.fl. 2014). Men i mange tilfælde er behandlingen unødvendig. Der er mange årsager til overbehandling med antibiotika, men denne artikel koncentrerer sig om én: betydningen af sproget for behandlingsforslaget og hvorvidt det accepteres eller afvises. Artiklen analyserer en enkelt dansk læge-patient-samtale, der bevæger sig fra et forslag om antibiotisk behandling til et forslag om ikke-antibiotisk næsespray, og viser, at behandlingsforslagets format kan have betydning for patientens villighed til at fravælge antibiotisk behandling. Ved hjælp af konversationsanalyse bliver de to behandlingsforslag (et for antibiotika og et efterfølgende for næsespray) analyseret i detaljer og årsagerne til accept af det andet forslag fremfor det første forslag diskuteres. Ved at designe behandlingsforslaget som en mulighed, patienten kan tilvælge, kan ordinering af antibiotika tilbagerulles eller undgås i de tilfælde, hvor det er medicinsk forsvarligt.