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The aim of this study was to gain an in-depth picture of communication processes throughout a single 'episode of care', and to better understand information flows and barriers within the health system. The team tracked individual patients referred from primary care to secondary care. Patients' interactions with health professionals were tracked and recorded as they entered the hospital system until their episode of care was completed. This data, along with additional consultation data from participating GPs, has been analysed using a multi-method approach to explore various aspects of communication with practical relevance to health care. These have included: variation and continuity over time, in different settings and modalities (e.g. agenda management, problem presentation & history taking, consultation talk vs. medical notes, GP vs. specialist consultations), computer use in the consultation, patient questions, lay vs. expert knowledge, shared decision-making, and communication on specific clinical topics such as lifestyle & health promotion talk, medication & prescribing talk (e.g. side effects, adherence, the use of evidence in antibiotic discussions), complementary and alternative medicine, mental health, communicative mismatches, delivery of diagnostic news.

Related work

2007-2010 A structural analysis of surgeon-patient consultations (PhD)

  • Sarah White

2012-2018 Communication in Surgical Encounters

  • Maria Stubbe
  • Tony Dowell
  • Lindsay Macdonald
  • Kevin Dew (VUW)
  • Sarah White
  • Prof. John Cartmill (Australian School of Advanced Medicine, Macquarie University)


  • NZ Royal Society Marsden Fund
  • University of Otago Research Fund
  • National Drug Policy Discretionary Grant Fund


Stubbe, M., S. J. White, L. Macdonald and K. P. Dew (2016). Do surgeons want to operate? Negotiating the treatment plan in surgical consultations. Communication in Surgical Practice. S. J. White and J. Cartmill, Equinox: 124-152.

White, S. J., M. Stubbe, K. P. Dew and R. Gardner (2016). The referred consultation: Communication in Surgical Practice. S. J. White and J. Cartmill, Equinox.

White, S. J., M. H. Stubbe, L. M. Macdonald, A. C. Dowell, K. P. Dew and R. Gardner (2014). Framing the consultation: the role of the referral in surgeon-patient consultations. Health Communication 29(1): 74-80.

Morgan, S. (2013). Miscommunication between patients and general practitioners: implications for clinical practice. Journal of Primary Health Care 5(2): 123-128.

White, S. J., M. H. Stubbe, K. P. Dew, L. M. Macdonald, A. C. Dowell and R. Gardner (2013). Understanding communication between surgeon and patient in outpatient consultations. ANZ Journal of Surgery 83(5): 307-311.

Dew, K., M. Stubbe, L. Macdonald, A. Dowell and E. Plumridge (2010). The (non) use of prioritisation protocols by surgeons. Sociology of Health & Illness 32(4): 545-562.


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