Triadic Medical Closing: Companions’ Participation in Raising Additional Concerns

ABSTRACT The introduction of additional concerns (ACs) during the closing phase of medical consultations—known as the “closing syndrome”—can compromise communicative efficiency by prolonging the interaction. The involvement of companions may further exacerbate this issue. However, studies on companion participation have predominantly centered on phases like diagnosis and treatment, with the closing phase being underexplored. Drawing on conversation analysis, this study examines how companions participate in raising ACs in consultation closings, exploring their sequential positioning, turn design, and impact on the termination of medical visits. The data consist of video recordings of 80 accompanied medical visits (approximately 920 min in total) by three doctors from two tertiary hospitals in mainland China. Findings reveal that companions initiate ACs themselves and respond to patient‐initiated ACs at four distinct sequential positions within the closing structure—after the closing‐implicative sequence, at the transition between the pre‐closing and closing sequences, upon completion of the closing sequence, and in response to the reopened interaction—employing position‐sensitive turn design. Notably, companions are more inclined than patients to introduce ACs as new topics, adopting sequence‐initiating rather than sequence‐responding actions—a behavior that underscores their agency and autonomy in shaping the consultation closure. Beyond revealing the complexities inherent in closing accompanied medical encounters, this study also contributes to distinguishing between multi‐party and multi‐person interactional phenomena. Furthermore, it offers practical implications for improving communicative efficiency in medical settings involving companions.