Book: Communication in Surgical Practice
Chapter: Chapter 6 . Do Surgeons Want to Operate? Negotiating the Treatment Plan in Surgical Consultations
Recent studies of decision making in surgical consultations suggest that surgeons may orient to surgery as a ‘default option’, as evidenced by recommendations not to operate tending to be interactionally more complex and requiring more extended negotiation than decisions in favour of surgery. This research also highlights the influence of patients on decision making, with treatment recommendations shown to be a joint achievement by surgeon and patient. However, it remains unclear to what extent contemporary patient-centred models of the consultation emphasising mutuality and shared decision making are reflected in surgical interactions. This chapter explores the naturally occurring interactional processes by which surgeons and patients reach decisions about treatment plans and how surgeons’ recommendations align (or not) with expressed patient wishes and concerns. The analysis draws on data from 47 video-recorded New Zealand surgical consultations in the ARCH Corpus of Health Interactions.