Problem Presentation in Accompanied Medical Consultations: Patterns for Multi-Person Participation.

Companions' participation in doctor-patient interaction increases the complexity of sequence organization. Based on a collection of audio/video-recordings of accompanied medical consultations in China's mainland, this study examines the difference in patients' and companions' manners of problem presentation. Adopting a conversation-analytical approach to naturally occurring interactions, we identify distinguishable practices between patients and companions during primary-concern presentations: patients are more inclined to describe the medical problem itself, whereas companions tend to recount the illness history rather than simply describing the problem. The tendency is evidenced by patients' and companions' action formation in both common and deviant cases of problem presentation, regardless of the sequential position (i.e. sequence-initiating or responding position) and participation type (joint vs. individual participation). Epistemics plays a pivotal role in shaping the distinct choice of conversational practices by patients and their companions when presenting problems. The study has implications both on improving the efficiency of accompanied medical consultations and on understanding the phenomenon of multi-person participation in interaction as a single party.