Configuring the Professional Touch in Physical Examinations in Chinese Outpatient Clinical Interaction: Talk, Touch, Professional Vision, and Intersubjectivity

ABSTRACT

Touch is a fundamental resource mobilized by clinicians in physical examinations in outpatient clinical consultations. However, few studies have been conducted to explore the sequential organization of touch in the interactional process of physical examinations where clinicians’ touch is launched and responded to in Chinese medical settings. Based on a collection of video recordings of naturally occurring clinician-patient interaction in an orthopedic outpatient clinic in China, we observed four types of clinicians’ touch in the physical examination framework: the guiding touch, the diagnostic touch, the demonstrative touch, and the therapeutic touch. Together with clinical expertise, the sensorial knowledge obtained through touch enables clinicians to professionally evaluate patients’ physical conditions and diagnose their illnesses. We also demonstrated that patients do not merely put themselves into clinicians’ hands as clinical objects for inspection and defer to clinicians’ medical authority. Instead, they actively and agentively participate in physical examinations to jointly accomplish social actions and activities through the temporal and sequential mobilization of their multimodal resources. This study not only adds to an emerging body of research on touch in medical settings but also sheds some light on the understanding of the clinician-patient interaction in Chinese outpatient clinics.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. The transcription conventions and the abbreviations are available from the corresponding author.

2. Although the clinician successfully moves the patient’s hand slightly upwards (comparing the location of the patient’s right middle finger in fig. 1.1 and fig.1.2), the patient’s hand does not hold above there; instead, the patient moves her hand downwards back to the original position, together with the clinician’s hand, as the patient shows the location in verbal and embodied ways in line 3.

3. In this local context, the patient touches the painful location with her fingers, rather than covering it as the patient does in Excerpt 1.

4. Notably, the clinician does not hold the weight of the patient’ foot; rather, the patient keeps his foot immobile in the air.

5. The Chinese proverb “miao shou hui chun” means the doctor effects a miraculous cure and bring the dying back to life. It uses exaggeration to express the high skill of the doctor.

6. We thank one of the anonymous reviewers for pointing this out.

Additional information

Funding

This work was supported by the Humanities and Social Sciences Youth Foundation, the Ministry of Education of the People’s Republic of China (22YJC740100), the National Social Science Fund of China (21BYY020), and the Key Project of the Social Science Foundation of Shandong Province (21BYYJ01). The Project of China Disabled Persons' Federation (2022CDPFHS-18). The views expressed in this study are only those of the authors and not necessarily those of the institutions.