"Patient counselling" by pharmacists: four approaches to the delivery of counselling sequences and their interactional reception.

'Patient counselling' by pharmacists is a diverse and ill-defined activity. It is also an activity which is achieving more prominence as part of the 'extended role' which is seen as the way forward for the profession. This paper uses data from a hospital paediatric outpatient clinic in the United Kingdom to examine the process of patient counselling from a conversation analytic standpoint, with a particular focus on the varying ways in which these sequences are set up and the ways in which patients or carers respond. Four types of interactional approach to negotiating entry into a broadly defined 'patient counselling' sequence are identified. These approaches are considered within the broader frameworks of delicacy, morality and competence which impact upon the giving and receiving of advice and information more generally, as well as in this setting, and in the light of the continued development of the 'extended role'.