Structures of expectations in communication involving migrant patients in andrology

This article presents the analysis of audio-recorded and transcribed medical encounters between andrologists and native and migrant patients with erectile dysfunctions. The article deals with reflexive expectations as basic structures of the medical system, showing that andrologists' actions contribute to undermine stable reflexive expectations in medical communication. The analysis shows that deficit in treatment of language barriers is only one single indicator of the more general problem of failure in structuring expectations concerning negotiation of information and patients' contributions. This failure prevents a patient-centred form of communication processes that involves migrant patients. [Publisher's Text].