Managing Calls to Mauri Ora: Medical Reception in Action

Often a patient’s first contact with their health service is through a medical receptionist. Literature has framed medical receptionists as gate-keepers, and few studies have examined what they actually do when they answer incoming calls by studying recordings of them. The current thesis asks how receptionists managed calls to Mauri Ora, a student health service, to deliver what the callers were asking for. The findings present evidence that receptionists are skilled and supportive in their interactions with patients.  Following discursive psychology and conversation analysis as theoretical and methodological frameworks this thesis examined naturally occurring social interactions to discover how joint understanding and coordinated action was accomplished. Eighteen (N=18) calls between receptionists and patients were recorded, transcribed and examined in detail for what happened in each call and how receptionists worked to deliver what the callers were asking for.  Callers ring with a broad range of different problems. The analysis documents how receptionists showed that they understood what callers wanted, and the ways they worked to progress solutions. The examination of requests for doctors’ appointments were of particular interest because of their very limited availability and the triage process for getting one. By establishing with the caller the conditions under which they could see a doctor, including if it was an urgent problem, receptionists opened the door to the health care being sought. A difficult matter for receptionists is asking for and responding to health-related information because they have no medical training. An additional aspect of the analysis demonstrated that receptionists only asked for medical information as a record for triage referral, and when it had not previously been disclosed.  Far from casting medical receptionists as gate-keepers withholding help, the current thesis demonstrates their orientation towards granting the requests of callers and doing what they can to facilitate access to health care. Practical applications for the training and practice of medical receptionists are considered as well as future research, and the ethical constraints of this kind of work.