Talking About Things: A Patient Cue for Sensitive Healthcare Problems and Effective Physician Responses

In routine healthcare consultations, patients often use prefaces containing the word thing, including the thing is, there's this thing or one more thing. Although thing is an all-encompassing term that is used in myriad ways, in this article we show that thing-prefaces perform a specific job. This study uses Conversation Analysis to analyze 90 video-recorded primary care consultations with 14 primary care physicians in the United States. Patients' thing-prefaces mark the upcoming talk as a disclosure of sensitive information that may reflect negatively on the patient, physician or service (e.g., medication nonadherence, refill was not sent to pharmacy). Patients pursue explicit resolution of these problems (e.g., personalized recommendation, lab work, referral) despite these problems being downplayed and treated as delicate. Because patients may talk around these sensitive issues, thing-prefaces can be an important cue for physicians that patients are seeking resolution for a sensitive healthcare problem.

Automated summary

In routine healthcare consultations, patients often use prefaces containing the word "thing" to signal that they are about to disclose sensitive information, despite these issues being downplayed, patients still seek explicit resolution.