‘Shift’ ‘n ‘control’: The computer as a third interactant in Spanish-language medical consultations.

The purpose of this paper is to examine the role of the computer in medical consultations in which English- Spanish-bilingual medical providers interact with Spanish-monolingual patients. Following previous studies that have revealed that the presence of the computer in consultations detracts from direct provider– patient communication, we pay specific attention to how the use of the computer in Spanish-language medical consultations can complement or adversely affect the co-construction of the patient’s health narrative. The data for the present study consist of 36 Spanish-language medical consultations in Southern California. Applying a conversation analytical approach to the health narratives in the corpus, we argue that the computer is essentially a third interactant to which medical providers orient through lowered volume, minimal responses, bureaucratic side talk, and, most importantly, code-switching to English – all of which strip the patients of control over the co-construction of their health narrative with their medical provider. Because the patient does not have access to the computational task and the language, we posit that this exacerbates the already existing adverse effects that the computer has on provider–patient interaction.