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Review
. 2016 Jul 19;4(1):12-18.
doi: 10.1002/ams2.229. eCollection 2017 Jan.

Online Commentary in Primary Care and Emergency Room Settings

John Heritage  1
Affiliations
Review

Online Commentary in Primary Care and Emergency Room Settings

John Heritage. Acute Med Surg. .

Abstract

This paper describes a communication practice called "online commentary" that is in widespread use in primary care in the USA. Online commentary is talk by a clinician that describes what he or she is finding in the course of the physical examination of the patient. The paper reviews the primary features of online commentary, with a special focus on its role in forecasting the likely results of the physical examination during the examination itself. It also describes patient outcomes that are associated with this use. It then uses data from an emergency room in the western USA to extend the notion of online commentary from primary care to the emergency setting. It proposes that online commentary facilitates effective teamwork by forecasting next actions, allowing members of the emergency team to anticipate probable next steps in the investigation and treatment of patient injuries.

Keywords: conversation analysis; emergency medicine; medical communication; online commentary; physical examination; primary care.

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References

    1. Heritage J, Stivers T. Online Commentary in Acute Medical Visits: a Method of Shaping Patient Expectations. Soc. Sci. Med. 1999; 49: 1501–17. - PubMed
    1. Mangione‐Smith R, Stivers T, Elliott M, McDonald L, Heritage J. Online Commentary During the Physical Examination: a Communication Tool for Avoiding Inappropriate Prescribing? Soc. Sci. Med. 2003; 56: 313–20. - PubMed
    1. Billings JA, Stoeckle JD. (eds). The clinical encounter: a guide to the medical interview and case presentation. Chicago: Year Book Medical Publishers, 1989.
    1. Zoppi KA. Interviewing as clinical conversation In: Mengel MB, Fields SA. (eds). Introduction to clinical skills: a patient‐centered textbook. New York: Plenum Medical Book Company, 1997; 41–55.
    1. Bates B, Bickley LS, Hoekelman RA. Physical examination: approach and overview In: Bates B, Bickley LS, Hoekelman RA. (eds). Physical examination and history taking, 6th edn Philadelphia: J. B. Lippincott Company, 1995; 115–35.