The use of a verbal response mode coding system in determining patient and physician roles in medical interviews

According to classic descriptions by Parsons (1951, 1969), the physician's role in medical interviews is characterized by high status and control vis-g-vis the patient. These complementary roles are not static, however, but shift substantially as the interview proceeds from taking a medical history, to conducting a physical examination, to concluding the interview with explanations and treatment plans. That is, although such interviews may be highly scripted-following a normative pattern that is predictable across patients and occasions-they are also complex, requiring a sequence of different relations between the roles to complete the necessary tasks. We used a verbal response mode (VRM; Stiles, 1992) coding system to derive quantitative indexes of physician and patient roles in three segments of each of eight medical interviews. We then used the indexes to characterize some of the complexity of these encounters.