{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:07:12Z","timestamp":1758931632789,"version":"3.44.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evaluating communication in clinical settings is essential for enhancing patient satisfaction and improving treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study examined the quality of consultations and communication practices used at a hospital\u2010based Danish Medical Spine Clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data included audio\u2010taped consultations with patients suffering from low back pain and subsequent patient interviews. The methodological approach to analysing consultation recordings was Conversation Analysis, while interviews were openly coded and analysed thematically. By comparing the services delivered by the healthcare professionals and the patients' reflections, effective and less effective practices were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analyses showed that (1) diagnostic and prognostic information provided, partly based on MR imaging, was generally perceived as satisfactory by patients, and (2) treatment plans were meaningful to patients and developed through a collaborative process. Moreover, (3) healthcare professionals' communication was clear and displayed an orientation towards achieving mutual understanding with patients. Finally, (4) an initial outline of the consultation facilitated alignment of expectations. However, the analyses also demonstrated discrepancies between patient expectations and the actual consultation experience concerning (1) the occupational background of the clinician, (2) the purpose of the consultation, and (3) the kind of help offered by the clinic. These mismatches contributed to lower patient satisfaction and prompted negotiations around epistemic authority and legitimation of professional identity during consultations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Improved alignment of patients' expectations could facilitate more effective consultations. Furthermore, despite the patients' satisfaction, the routine practice of explaining MR findings should be reconsidered based on recent evidence from prognostic research, which questions their relevance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.70134","type":"journal-article","created":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T19:39:53Z","timestamp":1752435593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Am I not Talking to any Medical Doctors Today?\u2019\u2014Evaluation of Effective and Ineffective Interactional Practices in Spinal Pain Clinic Consultations"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-3999","authenticated-orcid":false,"given":"Christina","family":"Emborg","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine University Clinic for Interdisciplinary Orthopaedic Pathways, Regional Hospital Central Jutland Silkeborg Central Denmark Region Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla Blach","family":"Rossen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University Clinic for Interdisciplinary Orthopaedic Pathways, Regional Hospital Central Jutland Silkeborg Central Denmark Region Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lise","family":"Hestb\u00e6k","sequence":"additional","affiliation":[{"name":"Regional Hospital Central Jutland, Medical Diagnostic Centre University Clinic for Innovative Patient Pathways Silkeborg Central Denmark Region Denmark"},{"name":"Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Region of Southern Denmark Denmark"},{"name":"The Chiropractic Knowledge Hub Odense Region of Southern Denmark Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"103","volume-title":"Handbook of Language and Social Interaction","author":"Heritage J.","year":"2005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.82199"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2021.05.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1811"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000700"},{"volume-title":"The Handbook of Conversation Analysis","year":"2013","author":"Sidnell J.","key":"e_1_2_11_7_1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_11_9_1","first-page":"533","volume-title":"The Handbook of Conversation Analysis","author":"Antaki C.","year":"2013"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369-6513.2001.00125.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327027hc1902_1"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0279-0"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327027HC1403_2"},{"volume-title":"Interviews: Learning the Craft of Qualitative Research Interviewing","year":"2015","author":"Brinkmann S.","key":"e_1_2_11_14_1"},{"key":"e_1_2_11_15_1","unstructured":"(Region Midtjylland2013).Forl\u00f8bsprogram for L\u00e6nderygsmerter.Region Midtjylland N\u00e6re Sundhedstilbud https:\/\/www.rm.dk\/globalassets\/zdesign\/media\/sundhed\/s."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/14614456020040040901"},{"key":"e_1_2_11_17_1","first-page":"57","volume-title":"the Handbook of Conversation Analysis","author":"Hepburn A.","year":"2013"},{"issue":"5","key":"e_1_2_11_18_1","first-page":"1410","article-title":"A Guide to Abductive Thematic Analysis","volume":"27","author":"Thompson J.","year":"2022","journal-title":"Qualitative Report"},{"key":"e_1_2_11_19_1","first-page":"321","volume-title":"Kvalitative Metoder","author":"Steensig J.","year":"2015"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1515\/text.2005.25.1.7"},{"volume-title":"Studies in Ethnomethodology","year":"1967","author":"Garfinkel H.","key":"e_1_2_11_21_1"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmh402"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-023-03406-9"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369-6513.2003.00235.x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2307\/2787032"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327973RLSI3502_5"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00148127"},{"key":"e_1_2_11_28_1","first-page":"71","volume-title":"Analyzing Discourse: Text and Talk","author":"Schegloff E. 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