Recommending surgical or non-surgical treatments in medical consultations: The case in Chinese contexts.

Abstract

This study examines the design and delivery of surgical and non-surgical treatment recommendations in China. We examined 936-minute recordings of medical consultations using conversation analysis. Data were collected from two tertiary hospitals in China. They are authentic interactions from the departments of orthopedics and proctology. Non-surgical treatment recommendations are proposed after diagnoses delivery. They are delivered in straightforward and simple form, and as already determined. Surgical treatment recommendations are proposed early and sometimes occupy the diagnostic slot. They are delivered in straightforward, simple, but mitigated form. These recommendations are formulated as a matter that is not fully settled and requires further discussions. Patients' stances toward specific treatments are made manifest in the tailoring of doctors' recommendations. The formulations of treatment recommendations exhibit doctors' understanding of what patients are anticipating or resisting. Chinese patients' preference for non-surgical treatments over surgery is reflected in how doctors present the recommendations for surgical and non-surgical treatments. Patients' concerns vary depending on the treatments recommended. Doctors should incorporate these concerns into their medical advice. In China, for non-surgical patients, the focus is on clearly explaining the treatment plan. For surgical patients, doctors should first assist them in making informed treatment decisions.