title: 'Keep complaining til someone listens': Exchanges of tacit healthcare knowledge in online illness communities.
abstract: This article examines online exchanges of advice and knowledge among patients. It draws a distinction between explicit healthcare knowledge (i.e., facts about symptoms and treatments) and tacit healthcare knowledge (i.e., know-how about navigating the healthcare system). Based on analysis of message board interactions at a prominent online illness community, I find that patients routinely encourage one another to exercise agency strategically in clinical encounters by honing specific interactional skills. I isolate three major techniques that are advocated within the community (affect regulation, information management, and treatment persistence) and frame them as discrete examples of tacit healthcare knowledge. I argue that tacit healthcare knowledge constitutes a potentially potent source of empowerment for patients that can help them to receive their desired form of care from the health system and to negotiate relationships with medical professionals and institutions. I conclude by discussing how the concept of tacit healthcare knowledge further clarifies the wide variety of lay knowledge exchanged among patients online.
authors.affiliation: University of Michigan, Room 3115 LSA Building, 500 S. State Street, Ann Arbor, MI 48109-1382, USA. Electronic address: dmfoster@umich.edu.
authors.forename: Drew
authors.initials: D
authors.lastname: Foster
mesh_terms: D000068598:Data Accuracy; D057220:Health Literacy / Q000592:standards*; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D020407:Internet; D010817:Physician-Patient Relations; D011209:Power, Psychological; D020377:Self Efficacy; D012657:Self-Help Groups / Q000639:trends*; D000078329:Workforce
keywords: Chronic illness; Internet; Patient empowerment; Patient-consumers; Tacit healthcare knowledge; Virtual ethnography