Physician-parent interaction in treatment decision in a pediatric department in a mainland China hospital

This paper examines the interaction between the physician and accompanying parents on treatment decision in pediatric consultations. Previous studies in the US context (Stivers 2002, 2005, 2006) have looked at parents’ responses to physicians’ treatment recommendation and analyzed the strategies used by parents to display resistance to suggested treatment. In this presentation, we use the methodology of Conversation Analysis (Sacks, Schegloff & Jefferson 1974; Hutchby and Wooffitt, 1998; Drew and Collins 2001; Maynard and Heritage 2006), and examined 60 video-recorded consultations, collected in a pediatric clinic in a mainland China hospital, primarily dealing with children with upper respiratory infection problems.Our data show that a number of strategies are used by parents to indicate their non-acceptance of physician’s prescribed treatment. These strategies include: (1) silence, (2) delay, and (3) statement of concerns, among which silence and delay are of the most common, while statement of concerns is less common. In response, physician may: (1) pursue acceptance by going back to the examination result, accounting for the treatment, or simply emphasizing the necessity of his plan; or (2) offer concessionary plans by incorporating accompanying adults’ opinions.