English summaries 16/2020 vsk 75 s. 968 - 973

In occupational health negotiations, the physician’s opening question to the employee directs the discussion towards either return-to-work solutions or disorders

Elina WeistePirjo Juvonen-PostiInka KoskelaHanna-Leena RistimäkiSanna PesonenHanna KeränenJohanna Ruusuvuori
Taulukko 1
Työterveyslääkärin avauspuheenvuoron kolme käytännettä
Taulukko 2


In the initial phase of the joint negotiations on an employee’s return-to-work solutions the physician opens the discussion by asking the employee to talk about their situation. Since the employer is present at the encounter, the participants are supposed to comply with the protection of privacy in working life. Thus, the extent to which issues concerning the employee’s medical history are discussed becomes relevant. In this paper we investigate how occupational health physicians invite employees to talk about their situation at the beginning of the joint negotiations, and how the employees respond to these invitations.


Twelve video-recorded occupational health negotiations were analyzed by conversation analysis.


Physicians’ opening questions inviting employees to talk about how they perceived their work ability were answered with descriptions that focused on return-to-work solutions. Physicians’ opening questions inviting employees to say how they saw their current condition, or leaving the employee to decide what to talk about, guided the employees to describe their medical history.


Physicians can guide the discussion towards either return-to-work solutions or the employee’s medical history through the design of their question.


Elina Weiste
VTT, erikoistutkija
Pirjo Juvonen-Posti
LT, johtava asiantuntija
Inka Koskela
YTM, tutkija
Hanna-Leena Ristimäki
YTM, tohtorikoulutettava
Tampereen yliopisto
Sanna Pesonen
TtM, tutkija
Hanna Keränen
LL, työterveyshuollon erikoislääkäri
Johanna Ruusuvuori
professori, YTT
Tampereen yliopisto

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