This article examines the role of medical interpreters in structuring interaction between physicians and their patients. Through a detailed analysis of interpreters' involvement in the history-taking part of medical consultations, it is demonstrated that their participation in this activity is organized by their understanding of its goals rather than by the task of translation alone. Specifically, the different ways in which interpreters participate in history taking display their orientation to obtaining from the patient and conveying to the doctor medically relevant information about the patient's symptoms - and doing so as effectively as possible. Medical interpreters are found to share the physicians' normative orientation to obtaining objectively formulated information about relevant biomedical aspects of patients' conditions. Thus, far from being passive participants in the interaction, interpreters will often pursue issues they believe to be diagnostically relevant, just as they may choose to reject patients' information offerings if they contain subjective accounts of their socio-psychological concerns.
Athorp, C. and Downing, B.T. (1996) `Modes of Doctor-Patient Communication: How Interpreter Roles Influence Discourse', paper presented at the 1996 Annual Conference of the American Association for Applied Linguistics, Chicago, March.
3.
Australian Bureau of Statistics (1997) 1996 Census of Population and Housing: Basic Community Profile. Canberra: Australia.
4.
Baker, D.W. , Parker, R.M., Williams, M.V., Coates, W.C. and Pitkin, K. (1996) `Use and Effectiveness of Interpreters in an Emergency Department', JAMA275(10): 783-788.
5.
Barsky, A.J. (1981) `Hidden Reasons Some Patients Visit Doctors', Annals of Internal Medicine94: 492-498.
6.
Bates, B. , Bickley, L.S. and Hoekelman, R.A. (1995) Physical Examination and History Taking (6th ed.). Philadelphia: J.B. Lippincott.
7.
Billings, J.A. and Stoeckle, J.D. (1989) The Clinical Encounter: A Guide to the Medical Interview and Case Presentation. Chicago: Year Book Medical Publishers.
8.
Boyd, E. and Heritage, J. (forthcoming) `Analyzing History-Taking in Primary Care: Questioning and Responding during Verbal Examination', in J. Heritage and D.W. Maynard (eds) Practising Medicine: Structure and Process in Primary Care Encounters. Cambridge: Cambridge University Press.
9.
Broeder, P. and Extra, G. (1999) Language, Ethnicity and Education: Case Studies on Immigrant Minority Groups and Immigrant Minority Languages. Philadelphia, PA: Multilingual Matters.
10.
Brooks, T.R. (1992) `Pitfalls in Communication with Hispanic and African-American Patients: Do Translators Help or Harm?', Journal of the National Medical Association84(11): 941-947.
11.
Byrne, P.S. and Long, B.E.L. (1976) Doctors Talking to Patients: A Study of the Verbal Behaviour of General Practitioners Consulting in their Surgeries. London: Her Majesty's Stationery Office.
12.
Downing, B.T. (1991, December) `Professional Interpretation: Ensuring Access of Refugee and Immigrant Patients', paper presented at the National Conference on the Health and Mental Health of Soviet Refugees, Chicago.
13.
Drew, P. and Heritage, J. (1992) `Analyzing talk at work: an introduction', in P. Drew and J. Heritage (eds) Talk at Work: Interaction in Institutional Settings, pp. 1-65. New York: Cambridge University Press.
14.
Fisher, S. (1991) `A Discourse of the Social: Medical Talk/Power Talk/Oppositional Talk?', Discourse and Society2(2): 157-182.
15.
Frankel, R.M. (1990) `Talking in Interviews: A Dispreference for Patient-initiated Questions in Physician-Patient Encounters', in G. Psathas (ed.) Interaction Competence, pp. 231-262. Washington, DC: University Press of America.
16.
Giacomelli, J. (1997) `A Review of Health Interpreter Services in a Rural Community: A Total Quality Management Approach', Australian Journal of Rural Health5(3): 158-164.
17.
Goodwin, C. (1994) `Professional Vision', American Anthropologist96(3): 606-633.
18.
Greenberger, N.J. and Hinthorn, D.R. (1993) History Taking and Physical Examination: Essentials and Clinical Correlates. St Louis, MO: Mosby Year Book.
19.
Grenoble, L.A. (1998) Deixis and Information Packaging in Russian Discourse. Philadelphia: John Benjamins.
20.
Hatton, D.C. (1992) `Information Transmission in Bilingual, Bicultural Contexts', Journal of Community Health Nursing9(1): 53-59.
21.
Hatton, D.C. and Webb, T. (1993) `Information Transmission in Bilingual, Bicultural Contexts: A Field Study of Community Health Nurses and Interpreters', Journal of Community Health Nursing10(3): 137-147.
22.
Heath, C. (1986) Body Movement and Speech in Medical Interaction. New York: Cambridge University Press.
23.
Heritage, J. and Sorjonen, M.-L. (1994) `Constituting and Maintaining Activities Across Sequences: and-prefacing as a Feature of Question Design', Language in Society23(1): 1-29.
24.
Hornberger, J.C. , Gibson, C.D.J., Wood, W., Dequeldre, C., Corso, I., Palla, B. and Bloch, D.A. (1996) `Eliminating Language Barriers for Non-English-Speaking Patients', Medical Care34(8): 845-856.
25.
Hornberger, J.C. , Itakura, H. and Wilson, S.R. (1997) `Bridging Language and Cultural Barriers Between Physicians and Patients', Public Health Reports112(5): 410-417.
26.
Knapp-Potthoff, A. and Knapp, K. (1986) `Interweaving Two Discourses: The Difficult Task of the Non-professional Interpreter', in J. House and S. Blum-Kulka (eds) Interlingual and Intercultural Communication: Discourse and Cognition in Translation and Second Language Acquisition Studies, pp. 151-168. New York: Mouton.
Larsson, U.S. , Säljö, R. and Aronson, K. (1987) `Patient-Doctor Communication on Smoking and Drinking: Lifestyle in Medical Consultations', Social Science and Medicine25(10): 1129-1137.
29.
Lerner, G.H. (1987) `Collaborative Turn Sequences: Sentence Construction and Social Action', unpublished PhD thesis, University of California at Irvine.
30.
Lipkin, M. Jr.Frankel, R.M. , Beckman, H.B., Charon, R. and Fein, O. (1995) `Performing the Interview', in M. Lipkin Jr, S.M. Putman, and A. Lazare (eds) The Medical Interview: Clinical Care, Education and Research, pp. 65-82. New York: Springer-Verlag.
31.
McWhinney, I. (1981) An Introduction to Family Medicine. New York: Oxford University Press.
32.
McWhinney, I. (1989) `The Need for a Transformed Clinical Method', in M. Stewart and D.T. Roter (eds) Communicating with Medical Patients. Newbury Park, CA: Sage.
33.
Meehan, A.J. (1981) `Some Conversational Features of the Use of Medical Terms by Doctors and Patients', in P. Atkinson and C. Heath (eds) Medical Work: Realities and Routines, pp. 107-127. Aldershot: Gower.
34.
Mishler, E.G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
35.
Pomerantz, A. (1984) `Agreeing and Disagreeing with Assessments: Some Features of Preferred/Dispreferred Turn Shapes', in J.M. Atkinson and J. Heritage (eds) Structures of Social Action: Studies in Conversation Analysis, pp. 57-101. New York: Cambridge University Press.
36.
Raymond, G. (1998) A Preference for Conforming Answers? Unpublished PhD proposal, Department of Sociology, UCLA.
37.
Robinson, J.D. (1999) `The Organization of Action and Activity in General Practice, Doctor-patient Consultations'. Unpublished PhD thesis, University of California, Los Angeles.
38.
Roter, D.T. and Hall, J.H. (1992) Doctors Talking with Patients/Patients Talking with Doctors: Improving Communication in Medical Visits. Westport, CT: Auburn House.
39.
Sacks, H. (1987) `On the Preferences for Agreement and Contiguity in Sequences in Conversation', in G. Button and J.R.E. Lee (eds) Talk and Social Organization, pp. 54-69. Philadelphia: Multilingual Matters.
40.
Sacks, H. , Schegloff, E.A. and Jefferson, G. (1974) `A Simplest Systematics for the Organization of Turn-taking for Conversation', Language50: 696-735.
41.
Sankar, A. (1986) `Out of the Clinic into the Home: Control and Patient-doctor Communication', Social Science and Medicine22(9): 973-982.
42.
Schegloff, E.A. (1987) `Analyzing Single Episodes of Interaction: An Exercise in Conversation Analysis', Social Psychology Quarterly50(2): 101-114.
43.
Schegloff, E.A. (1988) `Presequences and Indirection: Applying Speech Act Theory to Ordinary Conversation', Journal of Pragmatics12: 55-62.
44.
Schegloff, E.A. and Sacks, H. (1973) `Opening up Closings', Semiotica8(4): 289-327.
45.
Seidel, H.M. , Ball, J.W., Dains, J.E. and Benedict, G.W. (1995) Mosby's Guide to Physical Examination (3rd ed.). St Louis, MO: Mosby Year Book.
46.
Swartz, M.H. (1998) Textbook of Physical Diagnosis: History and Examination (3rd ed.). Philadelphia: W.B. Saunders.
47.
Ten Have, P. (1991) `Talk and Institution: A Reconsideration of the “Asymmetry” of Doctor-Patient Interaction', in D. Boden and D.H. Zimmerman (eds) Talk and Social Structure, pp. 138-163. Cambridge: Polity Press.
48.
Todd, A.D. (1984) “The Prescription of Contraception: Negotiating Between Doctors and Patients', Discourse Processes7: 171-200.
49.
Todd, A.D. (1989) Intimate Adversaries: Cultural Conflicts Between Doctors and Women Patients. Philadelphia: University of Pennsylvania Press.
50.
US Bureau of the Census (1993) Statistical Abstract of the US 1990 Census (113th edn.) Washington, DC: US Bureau of the Census.
51.
Wadensjö, C. (1992) Interpreting as interaction: On Dialogue-interpreting in Immigration Hearings and Medical Encounters. Linköping, Sweden: Linköping University.
52.
Wadensjö, C. (1998) Interpreting as Interaction. New York: Longman.
53.
Waitzkin, H. (1985) `Information Giving in Medical Care', Journal of Health and Social Behavior26(2): 81-101.
54.
Waitzkin, H. (1991) The Politics of Medical Encounters: How Patients and Doctors Deal with Social Problems. New Haven, CT: Yale University Press.
55.
Yokoyama, O.T. (1981) `On Sentence Coordination in Russian: A Functional Approach', in Papers from the 17th Regional Meeting, pp. 431-438. Chicago: Chicago Linguistic Society.
56.
Zoppi, K.A. (1997) `Interviewing as Clinical Conversation', in M.B. Mengel and S.A. Fields (eds) Introduction to Clinical Skills: A Patient-centered Textbook, pp. 41-55. New York: Plenum Medical Book Company.
