Medical recommendations as joint social practice

Treatment plans can be thought of as one of the products of a medical inter action. As such, treatment for illness has been investigated as an outcome measure and seems to reflect bias in some areas of the practice of medicine . Although the evidence for patterns of differential treatment is compellin g, determining the source of treatment bias has been difficult. Based on de tailed analysis of transcripts of actual interactions in general medicine a nd oncology clinics, we propose that treatment plans are negotiated through everyday language practices that work to maximize agreement. We demonstrat e that, on the level of individual medical encounters, patient agency is bo th apparent and operative and that physician power does not unilaterally de termine outcomes. Thus, this investigation goes beyond the abstract study o f physician and patient preferences or prejudices, focusing closely on the consequences of actual talk in settings where medical recommendations are b eing made.