A closing-implicative practice in Korean primary medical care openings

- Conversation analytic study of video-recordings to Korean medical care openings.
- Korean primary care openings tend to be compressed and goal-driven.
- The doctor's opening question limits the scope of patient response to a minimal form.
- Korean primary care openings are thus closing-implicative.

Prior studies on institutional interactions have identified the opening phase as an important topic of study (Heritage and Robinson, 2006; Robinson, 1998). This article employs conversation analysis to investigate the opening phase of videotaped acute primary care consultations in Korea to identify a closing-implicative practice (eti-ka apha-se-yo? “Where does it hurt?”), which might be understood as being culturally specific. First, the article shows that the structure of openings in Korean primary care interaction consists of reducing activities as part of achieving an as-early-as-possible occasioning of the solicitation question. Second, after analyzing the sequential structure of the solicitation strategy that is most frequently employed, the article argues that the grammatical structure of this solicitation strategy and its pragmatic force limit the possible scope of patients' responses to a minimal form (single TCU) describing the location (placement) of pain. The findings suggest that both the patient and doctor orient to the opening sequence as a path to history-taking by locating the primary problem. Implications of the finding for cross-cultural understandings of medical encounters are discussed.