Keeping the gate ajar during openings of general practice consultations

Abstract

A deferral of stance during the openings of general practice consultations is discussed in this paper as a possible systematic and important device for accomplishing gate keeping. The paper draws upon video recordings of naturally occurring consultations in Denmark. It is found that doctors defer their explicit stances when patients engage in a visit by requesting a specific clinical service (a prescription, a further test, a referral or a sick note etc). Instead of assuming a stance, doctors begin to ask the patients a series of questions, whilst withholding their ‘yes’ or ‘no’ throughout relatively long periods of time.