As part of the ESRC funded project The Practical Work of the Optometrist Helena Webb, Christian Heath, Dirk vom Lehn, Will Gibson and Bruce Evans have published an article concerned with the opening of optometric consultations in the journal Research on Language and Social Interaction. The paper particularly explored the sensitivity clients display to the use of the word ‘problem’ in the opening questions of the history taking.

The Problem With “Problems”: The Case of Openingsin Optometry Consultations

Abstract

This article contributes to conversation analytic understanding of openings in health-care consulta-tions. It focuses on the case of optometry: a form of health-care practice in which an optometristconducts checks of a patient’s vision and eye health. Patients are advised to attend regularly for rou-tine assessments and can also request a specific appointment at any time. Analysis of a corpus of 66 consultations shows what happens when the optometrist’s opening question solicits the client’s“problems” with their eyes. We find three types of patient response. Patients who have requested aspecific appointment (most often) report a problem with their eyes and establish a problem-purposeencounter. Patients attending for a routinely timed appointment either report no problems and estab-lish a routine-assessment purpose, or if they do have a problem, they delay reporting it or downplay it.We track through what happens subsequently. The findings have practical implications for diagnosisand treatment.