Communication in UK outpatient oncology consultations

This thesis is based on a sociological analysis of outpatient oncology consultations involving doctors and patients. Most patients have had surgery to remove their cancer. All have been referred for radiotherapy or chemotherapy and have been told on previous occasions that they have cancer. I demonstrate how information about cancer is managed between doctors and patients. Analysis draws on some of the insights and principles of applied conversation analytic work. I report on a range of short and long transcribed data fragments, drawn from a tape-recorded data corpus. Whilst respecting the "autonomy" of the recorded data, I occasionally and informally draw on observations made during fieldwork to crystallize analytic claims. Analytic foci are derived from the natural unfolding of the consultation trajectory. Three key topics are addressed: how doctors use history-taking to establish patient journeys to ascertain what patients know of their cancer; how diagnoses are embellished and treatment implications discussed; and how, within diagnostic and treatment talk, the participants negotiate the good, the bad and the uncertain character of the information shared. I revisit the broad (and predominant) policy and research literature to confirm the benefits of conversation analytic work and the particular insights provided by this thesis. I also delineate some of the broader themes to emanate from the detailed analysis and challenge some common conceptualisations of "doctor-patient communication". Finally, I close with a discussion of the limitations of this thesis and possibilities for further work.