A Discourse of the Social: Medical Talk/Power Talk/Oppositional Talk?

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Abstract
In the 1960s when federal policies in the United States were directed at countering societal inequalities, including inequalities in health care, a new health care professional came into being—the nurse practitioner. Nurse practitioners claim to provide care differently from doctors, to offer a system of care which adds caring to curing. Since the delivery of health care is essentially a communicational event and since overwhelmingly researchers have concentrated on doctor-patient communication, in this article I compare how nurse practitioner and doctor communicate with women patients during medical encounters and analyze the interactional and ideological work such communication does. Since nurse practitioners claim to provide just the kind of care that reformers are calling for—a more patient centered discourse of the social—this comparison allows me to address issues about how we understand the relationship between provider and patient—theoretical issues that are central to three recent sociological studies by Mishler, Waitzkin and Silverman.

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