The use of a verbal response mode coding system in determining patient andphysician 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 s hift substantially as the interview proceeds from taking a medical history, to conducting a physical examination, to concluding the interview with exp lanations and treatment plans. That is, although such interviews may be hig hly scripted-following a normative pattern that is predictable across patie nts and occasions-they are also complex, requiring a sequence of different relations between the roles to complete the necessary tasks. We used a verb al response mode (VRM; Stiles, 1992) coding system to derive quantitative i ndexes of physician and patient roles in three segments of each of eight me dical interviews. We then used the indexes to characterize some of the comp lexity of these encounters.