ABSTRACT
The medical encounter is centered on diagnosis and treatment: In lay terms, people go to the doctor to find out what’s wrong and what to do about it; in professional terms, the medical history and examination are the basis for the clinical reasoning that arrives at the differential diagnosis with its associated prognosis and course(s) of treatment (Wilson et al., 1991). In abstract terms, diagnosis represents the expertise of the physician, the leap to a conclusion warranted by medical education, training, and experience, and the delivery of that conclusion to the patient and/or family members (Parsons, 1951). In concrete interactions, however, diagnosis represents an interactional achievement of all the participants, not just the physician, although this achievement typically enacts and reflects the asymmetric framework characteristic of institutional encounters (Drew & Heritage, 1992).
