A conversation analytic study of calls to medical reception for doctor’s appointments

Abstract

A call to medical reception is regularly an entry point into primary health care services. Telephone-mediated interactions between patients and receptionists have been found to temper demand for doctor’s appointments and influence patient satisfaction ratings; yet little is known about what exactly happens to produce those effects. The present study asks how medical receptionists respond to telephone-mediated appointment requests. Audio recordings of 18 calls between receptionists and patients at a New Zealand University health care practice were collected, transcribed and examined in detail using conversation analysis. The findings reveal the complexity of telephone-mediated medical receptionist work which involves multiple engagements involving the caller and the on-line booking systems. The work has clinical components and evidence was found of receptionists’ orientations to the potential urgency of callers’ problems and how a triaging process was initiated. Overall, this study shows medical receptionists do skilful communicative work granting patient requests or progressing relevant courses of action in a clinically responsible way, thus delivering a valuable and unrecognised aspect of health care delivery. Keywords: primary health care; social interaction; mediated communication; telephone triage; qualitative, gendered work