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Co-Management In Healthcare: Negotiating Professional Boundaries, Catherine Schryer, Olga Gladkova, Marlee Spafford, Lorelei Lingard

Lorelei Lingard

This article investigates discursive practices associated with the co-management of patients between healthcare providers. Specifically, we focus on two genres (38 referral letters and 37 consultant reports) written by optometrists and ophthalmologists — two groups who are experiencing interprofessional tension over their scopes of practice. In our analysis we foreground four kinds of modality associated with verbs — epistemic, deontic, phatic and subjective. We found that these healthcare providers shared in the epistemic resources used to hedge their sense of clinical certainty, and that ophthalmologists used deontic resources to control future action. However, we also noted that both professions used …