Blurb:

Medical professionals’ areas of specialisation shape the types of problems that patients will consult them for, as well as the range of treatments patients will likely expect. However, patients do not always want the treatment that is recommended. This chapter considers how treatment decisions are negotiated in orthopaedic surgery consultations when patients resist surgeons’ recommendations. We examine factors that are interactionally brought to bear on the negotiation of treatment decisions between Canadian orthopaedic surgeons and patients, including the institutional bias towards surgery, matters of safety and risk, and patients’ medical history including length and severity of problems, and previous treatments. By examining how participants introduce, manage and resolve disagreements about treatment, this chapter sheds light on the complex interplay between orthopaedic surgeons’ medical specialisation, the institutional bias towards surgery, and patients’ expectations and treatment goals.