‘I don't know how to explain this’: problematic encounters between patients and receptionists in GP surgeries

Heather Hewitt

In this paper I examine several encounters between receptionists and patients at the front desks of GP surgeries in which interactional troubles occur. After providing brief profiles of the three GP practices where the naturally occurring interaction was recorded and giving some background information about receptionists and their work, I go on to examine several problematic encounters in some detail, illustrating my conclusions with reference to prosodic, lexico-grammatical and structural features of the discourse.

I find that, though receptionist talk shows some orientation to positive relational outcomes and attention to the face needs of patients, it is nevertheless frequently the case that institutional imperatives, such as the pressure to achieve rapid task completion, are more salient than interpersonal considerations. In addition, I show that the discourse of patients, while similarly motivated by instrumental goals, also incorporates troubles-tellings which, as Jefferson and Lee (1981) have demonstrated, can lead to interactional difficulties in the context of service encounters.