Conversation Analysis of Doctor-Patient Interaction in Primary Healthcare Centres in Ogun State

Doctor-patient interaction is a linguistically complex professional domain where communication quality directly affects diagnostic accuracy, treatment adherence, and patient satisfaction, and its systematic analysis using conversation analysis offers evidence-based insights into the micro-interactional mechanisms of healthcare communication quality. This study applies conversation analysis to doctor-patient consultations at six primary healthcare centres in Ogun State, examining opening sequences, history-taking, diagnosis delivery, and closing sequences as four analytically distinct interactional phases. Audio and video recordings of sixty consultations were collected with full informed consent from participating doctors and patients. Conversation analytic methods including sequential analysis, turn design examination, and repair sequence analysis were applied to the corpus. Findings reveal that consultation openings in all centres follow a standardized institutional format with limited opportunity for patient-initiated agenda-setting, a pattern that systematically disadvantages patients with multiple or complex concerns. History-taking sequences show a predominantly closed-question format that constrains patient narrative, with doctors rarely pursuing elaboration of patient-volunteered information. Diagnosis delivery episodes rarely include patient elicitation of understanding or concern, and closing sequences lack formal opportunity for patient questions in seventy-three percent of recorded consultations. Repair sequences show that communication breakdowns occur most frequently at diagnosis delivery, where technical vocabulary and Nigerian Pidgin-English mixing create comprehension gaps. The study recommends conversation analysis-informed communication skills training for primary healthcare doctors in Ogun State. Keywords: conversation analysis, doctor-patient interaction, primary healthcare, Ogun State, healthcare communication.