ABSTRACT
The medical dialogue is the fundamental instrument by which the doctor-patient relationship is crafted and by which problem solving and decision making regarding medical management and therapeutic goals are accomplished. Derived loosely from social exchange theories related to interpersonal influence, problem solving (Bales, 1950; Emerson, 1976), and reciprocity (Ben-Sira, 1976; Davis, 1969; Gouldner, 1960; Roter & Hall, 1989), the Roter Interaction Analysis System (RIAS; Roter, 1999) provides a tool for viewing the dynamics and consequences of patients' and providers' exchange of resources through the interaction of the medical dialogue. The social exchange orientation is consistent with health education and empowerment perspectives that view the medical encounter as a "meeting between experts" grounded in an egalitarian model of patient-provider partnership that rejects expert-domination and passive-patient roles (Freire, 1983; Roter, 1987,2000a, 2000b; Roter & Hall, 1991; Tuckett, Boulton, Olson, & Williams, 1985; Wallerstein & Bernstein, 1988).
