The use of reversed polarity repetitional questions during history taking

Relying on the methodology of conversation analysis, this study analyzes a systematic interactional practice involving one type of repetition found in acute primary care consultations, specifically during the oral history taking phase of the consultation. The data were recovered from video recordings of 42 primary care visits to six physicians in Korea. The article documents the physicians’ practice of repeating their questions by reversing the polarity of the repeated turn immediately following a patient's response. Reversed polarity repetitions used at these times are shown to work toward building a larger course of action; mainly they constitute diagnostic activity that indexes a patient's answer as being diagnostically significant. Based on empirical analysis of the data, it is argued that reversed polarity repetitions at these moments are not merely used to confirm a physician's understanding of symptoms. Rather, by doubly binding patients in their response, they are employed to address the relative importance of particular symptoms for forming diagnostic hypotheses. This paper contributes to the growing literature concerned with the interactional nature of everyday work in medicine by showing how the diagnostic logic of physicians can be realized in the interactive organization of history taking.