In the 1960s, feminists voiced their outrage about the health care system in the United States which routinely discriminated against women and, in so doing, literally jeopardized their health and well-being. Over a decade later, women's health advocates still stressed the need for reform of this male-dominated institution because of the on-going threat to the health of American women. In the 1990s, nearly 40 years after women began their fight for quality and equitable treatment from the medical profession, women unfortunately continue to confront problems on numerous levels including discrimination in medical research and in the availability of insurance and health care providers. Most alarming, however, is the fact that women today--like women in the '60s and before--lack information, understanding, and adequate diagnoses and treatment from their health caregivers. This book extends from a program of research on women's health issues by the authors. More than 150 audio-taped, naturally occurring interactions between health caregivers and their female patients from three different health care settings--as well as ethnographic field notes in three additional settings which provide health care to women-- constitute the data for this investigation. They explore the consequentiality of relational issues during women's health care encounters and examine how health care participants save face, enact roles, co-construct their encounters, and accomplish the objective of education and medical care. Unlike earlier works, this study utilizes an extensive data collection derived directly from hundreds of interactions between health care providers and their patients, as opposed to surveys or case studies of singular practitioners. The authors examine the data in light of insights from a variety of theoretical perspectives and are committed to exploring the implication that medical encounters are collaboratively managed by both patients and caregivers. Given these theoretical and empirical contributions, the authors believe this book will advance present understanding in the areas of health and relational communication, women's health care, gender issues in communication, conversation analysis, discourse processes, and institutional talk.
