Enquiry calls to GP surgeries in the UK: expressions of incomplete service and dissatisfaction in closing sequences

Abstract

This paper examines patients’ calls to three different GP services in the United Kingdom. Using conversation analysis, combined with coding of 447 calls, we studied the role of thank you in closing sequences, focussing on their timing and order in relation to service outcome. We show, first of all, how patients withhold thank you in orientation to an absent summary or specification of service: patients are more likely to initiate thank you if the receptionist volunteers such a summary. Secondly, we show there is variation in how appropriately participants project the termination of calls using thank you. And, finally, while thank you serves a primary role in managing the termination of calls, the timing, order and design of thank you can also display patient (dis)satisfaction. We discuss our findings in terms of service encounters more generally, including implications for larger-scale analysis.