Institutional discourse typically involves a dialectic between institutional (e.g. medical) frames and socio-relational frames for talk. The paper draws on audio-recorded data from a geriatric outpatients clinic in the UK to show how doctors and elderly patients collaborate in and negotiate the work of entering an apparently medical frame of talk. Particular attention is paid to sequences involving how are you?-type elicitations. Social and medical framings of talk are established and blended in complex discourse patterns. This blending may have a special salience in contexts, such as geriatrics, where holistic care has an explicit priority.
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