In microsociological studies of talkas social action, the active subjectis typically depicted as someone who interacts rather than acts. In other words, conversations produce intersubjective understandings rather than meanings based on the referential and semantic contents of talk. This paper formulates an alternative approach to the analysis of institutional conversations, based on an expanded unit of action. In this expanded unit, people act on a jointly constructed object which is outside the “social system” constituted by the parties themselves. Bakhtin's notions of utterance, social language, speech genre and voice are interpreted and integrated into a coherent system within the framework of activity theory. The proposed theoretical approach is applied in an examination of transcript data from videotaped doctor‐patient encounters from a Finnish primary care clinic. A set of voices present in medical consultations is identified. Analyses of data examples demonstrate the robustness of this set of voices as well as the appearance of new, emergent voices in sequences of locally produced interactional disturbance and innovation.
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Ritva Engeström (1995) studied this question.
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