Naturally Occurring Interactions and Guidance Codifications in Healthcare Communication Analysis: the Case of Praising Obese Patients

Abstract: Studies of face-to-face communication illuminate the ways in which the conduct and outcome of healthcare encounters is contingent on the interactions that occur within them. Work in this field benefits from the increasing availability and acceptance of recording technologies for data collection, enabling the production of richly detailed investigations of real-time healthcare communication. At the same time the growing interest within healthcare professions in inter-personal communication has lead to codification of interactional practices in guidance and training documents. This article argues that the intersection of these two developments presents a significant opportunity for fruitful research: analyses of naturally occurring communication in consultations can take the interactional practices prescribed in guidance and training documents as a topic or starting point for investigation. The subsequent results enhance empirical and conceptual knowledge whilst also offering a commentary on the guidance prescriptions. To demonstrate this, the article reports on a conversation analytic investigation of compliments in specialist obesity consultations prompted by guidance recommending the praise of these patients ‘every opportunity’. The findings reveal that the actions of praise-giving and response are interactionally complex in this kind of setting and closely associated with certain institutional and normative dynamics, thereby the guidance is less straightforwardly positive than it at first appears. By advancing analytic understanding and offering practical implications this kind of approach makes a substantial contribution to the interpersonal level of healthcare communication analysis