Måseide (2007) indicates that politeness and carefulness are important aspects of successful intraprofessional negotiations in health care. In this presentation, I will argue that face work (Goffman 1959) is vital to the success also of interprofessional collaboration. Based on analyses of discursive practices in a pain rehabilitation team (see also Lundgren 2009), the presentation focuses on a pragmatic strategy used by the team members, which appears to be one of the keys to the successful collaboration in this particular team.
The strategy, which I call “testing the waters”, is based on a specific five part construction: 1) announcement, 2) response, 3) elaboration, 4) initiation of discussion and 5) conclusion. It may be initiated in three different ways: by a) indicating a lack of certainty, b) making a reflection or c) sending out a feeler. The first three parts of the construction is similar both to Maynard’s description of the beginning of news delivery sequences in physician-patient interaction (Maynard 2003) as well as to the questioning sequences in workplace meetings described by Ford (Ford 2008). However, there are also important differences which will be addressed in the presentation.
By “testing the waters”, any team member can raise a potentially problematic issue at virtually any point of the team conference. Simultaneously, “testing the waters” enables discussions that may be sensitive, without threatening the face of the colleagues (or of the team member raising the issue). The discussions often lead to a review of previously made decisions, or a decision about a previously undiscussed point. According to the team members, these discussions can be understood as the team’s raison d’être, since they allow them to make the most of the variety of professional perspectives represented in the team and thereby to reach a genuinely shared understanding of the patient’s problems.
The results are based on discourse analyses of 15 video recordings of team conferences in the pain rehabilitation team.
References:- Ford, C. E. 2008. Women Speaking up. Getting and using turns in workplace meetings. New York: Palgrave. - Goffman, E. 1959. The Presentation of Self in Everyday Life. New York: Doubleday. - Lundgren, C. 2009. Samarbete genom samtal. En samtalsanalytisk studie av multiprofessionella teamkonferenser inom smärtrehabilitering. [Team Talk: Collaboration through Communication in Meetings of a Multiprofessional Pain Rehabilitation Care Team] Linköping Studies in Arts and Science 483. Linköping: Linköping University. - Maynard, D. W. 2003. Bad News, Good News: Conversational order in everyday talk and clinical settings. Chicago: Chicago University Press. - Måseide, P. 2007. Discourses of collaborative medical work. Text and Talk, 27 (5/6): 611-632.
COMET 2009: Communication, Medicine and Ethics, 25-27 June, Cardiff University, UK