56 DOC: This is just what I've been seeing. 57 MOM: [ (Okay.) 58 DOC: [ (O:kay,) 59 DOC: 60 61 62 MOM: 63 DOC: 64 DOC: 65 66 67 MOM: 68 DOC: 69 MOM: 70 DOC: [ .hh 71 DOC: 72 73 MOM: 74 DOC: 75 76 MOM: 77 DOC: 78 DOC: 79 80 MOM: 81 DOC: Okay, 82 DOC: 83 84 85 MOM: 86 DOC: .hh Uhm: if she's not running uh fever an' only ran thuh fever for uh day I'd really ra:ther: not put 'er on antibiotics if I can help it. Yeah. Okay, .hh There's s::o much out there now: about: (.) %#23w:%what happens with these kids with thuh:- resistance tuh thuh a[ntibiotics. Okay, [Right. [(Right. Uh:m: I would give her Tylenol if thuh fever comes back, Mm h[m, [Mka:y, If thuh fever persists through thuh weekend .hh I've gotta take another look. Mm hm, = = Okay, .hh Uhm, (.) I would use something like uh dimetap dee em, if she starts tuh get congested an' cough, Mm hm, .hh Uh: I'd give 'er lots of fluids::, -I'd pick up some Sucrets: :=er: ya know Chloraseptic er- [some in: some'in' hard tuh suck on fer thuh .hh= [Okay. =fer thuh relief uh thuh throat, ) 87 MOM: Mm hm:, 88 DOC: Okay:, 89 DOC: .hh And uhm: let's- let's keep an eye on 'er. 90 MOM: 91 DOC: 92 MOM: 93 DOC: 94 DOC: 95 96 97 98 MOM: Mm hm, 99 DOC: 100 101 102 103 (.) 104 MOM: 105 DOC: 106 MOM: [Mm hm, 107 DOC: 108 PAT: 109 DOC: .hh [(Eh-)/ (An-) do you have uh preference as to: children's= [(Okay:, =tylenol or thuh children's advil now that they h[ave? [.hh Ya know: what- what- it's interesting you ask that because (0.2) what we have found now. is is that .hh fever is actually- thuh best way tuh clear (0.2) something from your body, .hh An' a:11 of the:se - th- they r actually ran studies. A:nd, .hh they: uh: (m) found that .hh if you suppress thuh fever (0.5) you end up having thuh virus in your body (0.2) longer. Mmmm-mm=mm (.)/(,) Okay, Now. Does that mean you don't give 'em any [tylenol=er= [% 23HUH .h huh#3 any: A-dvil er whatever?, 110 DOC: .hh N:O(,) 111 (.) 112 DOC: 113 It means that (0.2) if thuh temperature: is low grade. (.) 1 Viral Sore Throat 2 Friday, Oct 4 1996, late afternoon 3 4 ((The mom has taken her daughter to the doctor because of a sore throat and fever. She's 5 6 7 missed one day of school yesterday; today her fever is down but throat is still sore. The doctor has just completed the history taking and physical exam, and now begins presenting the diagnostic conclusions and treatment recommendations.)) 8 9 DOC: 10 11 MOM: DOC: DOC: 14 MOM: DOC: 19 DOC: 20 MOM: DOC: 24 PAT: DOC: PAT: DOC: 29 30 DOC: MOM: =2B15678222222222228-2372687777777856676 .hh Okay. .hh She ↑looks: like one: hh of: thuh viral: sore throats: th't's been goin' around. Mm hm:,= =Okay, .hh Uhm: h We have not ha:d (1.1) uh lot of strep throa:t er: things that need antibiotics at thuh moment. Thuh kids ('ve kinduv all went back tuh schoo: 1,) Mm hm:, =And they're all sharing all these::=silly little: viruses. [.hhh [Mm hm:, Uh:m, (0.2) tlk=What (.) I would (0.4) recommend is is that if thuh fever (0.5) .hh Was your throat worse: yesterday or today::- or: - w- what. hh Uhm, (0.4) tlk=I think it was: hh (0.5) worser today. It was worser today?, But it's startin' tuh go down now. It's startin' tuh feel better? (.) Okay.= =She had no symptoms yesterday during thuh day except thuh- thuh temperature? .hh An' then last night: she started sayin' it: was kind (uv) hurting when she swallowed an' then this morning, .hh Okay, 33 34 DOC: MOM: So it wasn't like uh real major (h-) [( ) DOC: [Right. (1.0) 39 DOC: 40 DOC: 41 42 43 44 DOC: 45 46 PAT: 47 48 49 50 DOC: MOM: DOC: 54 MOM: So it's like- kinda (0.5) (yeow:.??) .hhh Uh:m:- (1.0) -hhh I wish(ed) it weren't Friday it'd be uh little bit easier I'd watch='er for uh day er two without worrying about 'er. (1.0) .hh Uhm, (0.2) How bad do you feel. (1.0) I'm startin' tuh feel better except fer .h%3h- (.) #huh huhm#. (0.2) like .hh when I sometimes I breathe (some-) (ya know) my throat will get clogged up 'n stuff, Okay. .hh Now see sh- she's gonna congest u:p. (.) Uh huh, She's gonna get uh good cough outta thi:s, She's going: to: get all mucusy, I mean- Mm hm,

Social Psychology (10th Edition)
10th Edition
ISBN:9780134641287
Author:Elliot Aronson, Timothy D. Wilson, Robin M. Akert, Samuel R. Sommers
Publisher:Elliot Aronson, Timothy D. Wilson, Robin M. Akert, Samuel R. Sommers
Chapter1: Introducing Social Psychology
Section: Chapter Questions
Problem 1RQ1
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Related questions
Question

Treatment Recommendations


The transcript below is the entire diagnosis and treatment phase of a primary care encounter
involving a mom and her sick daughter who has had symptoms of sore throat and fever.
Address these two questions regarding the doctor’s treatment recommendations.


Question 1: Affirmative treatment recommendations:
Focus on the doctor’s affirmative recommendations, which are mainly for over-the-counter
medications (not prescriptions), in lines 71-72, 78-79, 82-86, and 123-134 (in boldface).
• 1a: Using the recommendation formats sketched by Heritage in his last lecture
(pronouncement/proposal/suggestion/offer/assertion), which format or formats is the
doctor using? Explain.
• 1b: Given your answer to 1a, how would you characterize the doctor’s overall style of
recommendation? Are they relatively authoritative or relatively collaborative in their
approach, and to what extent?

Question 2: Ruling out antibiotics:
Before getting to the affirmative recommendations, the doctor rules out the possibility of an
antibiotics prescription (in lines 9-70). What are the main arguments the doctor puts forward
that, directly or indirectly, supports this decision to not prescribe antibiotics?
• Focus only on lines 9-70 for this question. Identify the main arguments and line
numbers where they are put forward, and briefly comment on how each argument is
being built

56 DOC:
This is just what I've been seeing.
57
MOM:
[ (Okay.)
58
DOC:
[ (O:kay,)
59
DOC:
60
61
62
MOM:
63
DOC:
64
DOC:
65
66
67
MOM:
68
DOC:
69
MOM:
70
DOC:
[ .hh
71
DOC:
72
73
MOM:
74
DOC:
75
76 MOM:
77
DOC:
78
DOC:
79
80
MOM:
81
DOC:
Okay,
82
DOC:
83
84
85
MOM:
86
DOC:
.hh Uhm: if she's not running uh fever an' only
ran thuh fever for uh day I'd really ra:ther:
not put 'er on antibiotics if I can help it.
Yeah.
Okay,
.hh There's s::o much out there now: about: (.) %#23w:%what
happens with these kids with thuh:- resistance tuh
thuh a[ntibiotics.
Okay,
[Right.
[(Right.
Uh:m: I would give her Tylenol if thuh fever comes
back,
Mm h[m,
[Mka:y, If thuh fever persists through thuh
weekend .hh I've gotta take another look.
Mm hm, =
= Okay,
.hh Uhm, (.) I would use something like uh dimetap
dee em, if she starts tuh get congested an' cough,
Mm hm,
.hh Uh: I'd give 'er lots of fluids::, -I'd pick up
some Sucrets: :=er: ya know Chloraseptic er-
[some in: some'in' hard tuh suck on fer thuh .hh=
[Okay.
=fer thuh relief uh thuh throat,
)
87
MOM:
Mm hm:,
88
DOC:
Okay:,
89
DOC:
.hh And uhm: let's- let's keep an eye on 'er.
90
MOM:
91
DOC:
92
MOM:
93
DOC:
94
DOC:
95
96
97
98
MOM:
Mm hm,
99
DOC:
100
101
102
103
(.)
104 MOM:
105 DOC:
106 MOM:
[Mm hm,
107 DOC:
108 PAT:
109 DOC:
.hh [(Eh-)/ (An-) do you have uh preference as to: children's=
[(Okay:,
=tylenol or thuh children's advil now that they h[ave?
[.hh
Ya know: what- what- it's interesting you ask that
because (0.2) what we have found now. is is that .hh
fever is actually- thuh best way tuh clear (0.2) something
from your body,
.hh An' a:11 of the:se
-
th- they r actually ran studies.
A:nd, .hh they: uh: (m) found that .hh if you suppress
thuh fever (0.5) you end up having thuh virus in your
body (0.2) longer.
Mmmm-mm=mm (.)/(,)
Okay,
Now. Does that mean you don't give 'em any [tylenol=er=
[% 23HUH .h huh#3
any: A-dvil er whatever?,
110
DOC:
.hh N:O(,)
111
(.)
112
DOC:
113
It means that (0.2) if thuh temperature: is low grade.
(.)
Transcribed Image Text:56 DOC: This is just what I've been seeing. 57 MOM: [ (Okay.) 58 DOC: [ (O:kay,) 59 DOC: 60 61 62 MOM: 63 DOC: 64 DOC: 65 66 67 MOM: 68 DOC: 69 MOM: 70 DOC: [ .hh 71 DOC: 72 73 MOM: 74 DOC: 75 76 MOM: 77 DOC: 78 DOC: 79 80 MOM: 81 DOC: Okay, 82 DOC: 83 84 85 MOM: 86 DOC: .hh Uhm: if she's not running uh fever an' only ran thuh fever for uh day I'd really ra:ther: not put 'er on antibiotics if I can help it. Yeah. Okay, .hh There's s::o much out there now: about: (.) %#23w:%what happens with these kids with thuh:- resistance tuh thuh a[ntibiotics. Okay, [Right. [(Right. Uh:m: I would give her Tylenol if thuh fever comes back, Mm h[m, [Mka:y, If thuh fever persists through thuh weekend .hh I've gotta take another look. Mm hm, = = Okay, .hh Uhm, (.) I would use something like uh dimetap dee em, if she starts tuh get congested an' cough, Mm hm, .hh Uh: I'd give 'er lots of fluids::, -I'd pick up some Sucrets: :=er: ya know Chloraseptic er- [some in: some'in' hard tuh suck on fer thuh .hh= [Okay. =fer thuh relief uh thuh throat, ) 87 MOM: Mm hm:, 88 DOC: Okay:, 89 DOC: .hh And uhm: let's- let's keep an eye on 'er. 90 MOM: 91 DOC: 92 MOM: 93 DOC: 94 DOC: 95 96 97 98 MOM: Mm hm, 99 DOC: 100 101 102 103 (.) 104 MOM: 105 DOC: 106 MOM: [Mm hm, 107 DOC: 108 PAT: 109 DOC: .hh [(Eh-)/ (An-) do you have uh preference as to: children's= [(Okay:, =tylenol or thuh children's advil now that they h[ave? [.hh Ya know: what- what- it's interesting you ask that because (0.2) what we have found now. is is that .hh fever is actually- thuh best way tuh clear (0.2) something from your body, .hh An' a:11 of the:se - th- they r actually ran studies. A:nd, .hh they: uh: (m) found that .hh if you suppress thuh fever (0.5) you end up having thuh virus in your body (0.2) longer. Mmmm-mm=mm (.)/(,) Okay, Now. Does that mean you don't give 'em any [tylenol=er= [% 23HUH .h huh#3 any: A-dvil er whatever?, 110 DOC: .hh N:O(,) 111 (.) 112 DOC: 113 It means that (0.2) if thuh temperature: is low grade. (.)
1
Viral Sore Throat
2
Friday, Oct 4 1996, late afternoon
3
4
((The mom has taken her daughter to the doctor because of a sore throat and fever. She's
5
6
7
missed one day of school yesterday; today her fever is down but throat is still sore. The doctor
has just completed the history taking and physical exam, and now begins presenting the
diagnostic conclusions and treatment recommendations.))
8
9
DOC:
10
11
MOM:
DOC:
DOC:
14
MOM:
DOC:
19
DOC:
20
MOM:
DOC:
24
PAT:
DOC:
PAT:
DOC:
29
30 DOC:
MOM:
=2B15678222222222228-2372687777777856676
.hh Okay. .hh She ↑looks: like one: hh of: thuh
viral: sore throats: th't's been goin' around.
Mm hm:,=
=Okay,
.hh Uhm: h We have not ha:d (1.1) uh lot of strep throa:t
er: things that need antibiotics at thuh moment. Thuh
kids ('ve kinduv all went back tuh schoo: 1,)
Mm hm:,
=And they're all sharing all these::=silly little:
viruses.
[.hhh
[Mm hm:,
Uh:m, (0.2) tlk=What (.) I would (0.4) recommend
is is that if thuh fever (0.5) .hh Was your throat
worse: yesterday or today::- or: - w- what. hh
Uhm, (0.4) tlk=I think it was: hh (0.5) worser
today.
It was worser today?,
But it's startin' tuh go down now.
It's startin' tuh feel better?
(.)
Okay.=
=She had no symptoms yesterday during thuh day except
thuh- thuh temperature? .hh An' then last night: she
started sayin' it: was kind (uv) hurting when she
swallowed an' then this morning, .hh
Okay,
33
34
DOC:
MOM:
So it wasn't like uh real major (h-) [(
)
DOC:
[Right.
(1.0)
39 DOC:
40 DOC:
41
42
43
44 DOC:
45
46
PAT:
47
48
49
50 DOC:
MOM:
DOC:
54
MOM:
So it's like- kinda (0.5) (yeow:.??)
.hhh Uh:m:- (1.0) -hhh I wish(ed) it weren't Friday
it'd be uh little bit easier I'd watch='er for
uh day er two without worrying about 'er.
(1.0)
.hh Uhm, (0.2) How bad do you feel.
(1.0)
I'm startin' tuh feel better except fer .h%3h- (.)
#huh huhm#. (0.2) like .hh when I sometimes I
breathe (some-) (ya know) my throat will get clogged
up 'n stuff,
Okay. .hh Now see sh- she's gonna congest u:p.
(.)
Uh huh,
She's gonna get uh good cough outta thi:s, She's
going: to: get all mucusy, I mean-
Mm hm,
Transcribed Image Text:1 Viral Sore Throat 2 Friday, Oct 4 1996, late afternoon 3 4 ((The mom has taken her daughter to the doctor because of a sore throat and fever. She's 5 6 7 missed one day of school yesterday; today her fever is down but throat is still sore. The doctor has just completed the history taking and physical exam, and now begins presenting the diagnostic conclusions and treatment recommendations.)) 8 9 DOC: 10 11 MOM: DOC: DOC: 14 MOM: DOC: 19 DOC: 20 MOM: DOC: 24 PAT: DOC: PAT: DOC: 29 30 DOC: MOM: =2B15678222222222228-2372687777777856676 .hh Okay. .hh She ↑looks: like one: hh of: thuh viral: sore throats: th't's been goin' around. Mm hm:,= =Okay, .hh Uhm: h We have not ha:d (1.1) uh lot of strep throa:t er: things that need antibiotics at thuh moment. Thuh kids ('ve kinduv all went back tuh schoo: 1,) Mm hm:, =And they're all sharing all these::=silly little: viruses. [.hhh [Mm hm:, Uh:m, (0.2) tlk=What (.) I would (0.4) recommend is is that if thuh fever (0.5) .hh Was your throat worse: yesterday or today::- or: - w- what. hh Uhm, (0.4) tlk=I think it was: hh (0.5) worser today. It was worser today?, But it's startin' tuh go down now. It's startin' tuh feel better? (.) Okay.= =She had no symptoms yesterday during thuh day except thuh- thuh temperature? .hh An' then last night: she started sayin' it: was kind (uv) hurting when she swallowed an' then this morning, .hh Okay, 33 34 DOC: MOM: So it wasn't like uh real major (h-) [( ) DOC: [Right. (1.0) 39 DOC: 40 DOC: 41 42 43 44 DOC: 45 46 PAT: 47 48 49 50 DOC: MOM: DOC: 54 MOM: So it's like- kinda (0.5) (yeow:.??) .hhh Uh:m:- (1.0) -hhh I wish(ed) it weren't Friday it'd be uh little bit easier I'd watch='er for uh day er two without worrying about 'er. (1.0) .hh Uhm, (0.2) How bad do you feel. (1.0) I'm startin' tuh feel better except fer .h%3h- (.) #huh huhm#. (0.2) like .hh when I sometimes I breathe (some-) (ya know) my throat will get clogged up 'n stuff, Okay. .hh Now see sh- she's gonna congest u:p. (.) Uh huh, She's gonna get uh good cough outta thi:s, She's going: to: get all mucusy, I mean- Mm hm,
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