ABSTRACT
This chapter looks at the way in which patient or health practitioner concerns about side effects are dealt with in the clinic, focusing on analysis of the interactional dynamics of the consultation. Conversation analysis is used to examine these dynamics in detail. This analysis identifies a number of features of interactions in consultations that can downplay the recognition of side effects. When patients present their concerns about side effects, they are likely to do this in a vague and hesitant way. I argue that their concerns are presented in this way so that any threat to the face of the health professional, who usually prescribed the medication, is minimised. When patients present their concerns, general practitioners are most likely to explain away their concerns or even ignore them. As the primary therapeutic intervention of general practice is a medical prescription, it is understandable that general practitioners usually downgrade patient concerns. However, in doing so, general practitioners foster underreporting of side effects and limit the efficacy of pharmacovigilance efforts.
