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The chapter follows a body of social-science literature that has significantly impacted how doctors and other health professionals are trained and the fine-grained, moment-to-moment dynamics of how they interact with patients. The purpose of the guidelines they promote is to help caregivers listen more sensitively to their patients and increase patients’ engagement with providers. However, this emphasis can impose biocommunicability in ways can stigmatize patients as incommunicable failures, thereby affecting health outcomes and patients’ confidence in providers and forms of care. The analysis uses Michael Silverstein’s notion of “indexical orders” to analyze how physicians thwart collaboration with patients in bringing the contexts in which health problems arise into the discursive order of the clinic. Research on nonbiomedical treatment suggests the importance of forms of communication that lie outside of biocommunicable parameters.

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