Dealing with parental concerns: A study of GPs' practice.

OBJECTIVE:To investigate patterns of GPs' exploration and termination of dialogues about parental concerns in preventive child health assessments. METHODS:Interactional microanalysis of video recordings of 32 preventive child health assessments using conversation analysis. RESULTS:The GPs asked parents about concerns, but most concerns disclosed by parents were still left unexplored at the end of the consultation. Termination of dialogues about concerns could be achieved effectively by GPs through letting the biomedical agenda dominate or addressing the child directly. The parents generally cooperated with the various approaches to handling concerns. CONCLUSION:GPs displayed initial attentiveness towards emotional concerns but did not always follow through with subsequent exploration; many concerns raised were left unexplored. However, the same GP could employ both non-exploratory and exploratory practice within individual consultations. PRACTICE IMPLICATIONS:Preventive child heath assessments offer an opportunity for parents to raise concerns about their children's development. Improved understanding of the conversational mechanisms through which concerns are examined or sidelined could allow clinicians to maximise the effectiveness of their preventive consultations.