“Is it useful to talk to other cancer patients?”: A discourse study of lay perceptions of knowledge and expertise in an online support group

A growing body of research highlights how patients’ use of the Internet, including constructing, sharing personal stories, and accessing knowledge online, gives rise to a new form of lay expertise, which may further challenge the expertise of medical professionals. Accentuating patients’ perspectives, this paper investigates the variety of positions Chinese cancer patients articulate and adopt regarding knowledge and expertise within an online support group. My analyses demonstrate that, despite being highly proactive and reflexive, these patients actually reproduce and reinforce the dualistic positioning of doctor and patient within broader discourses of scientific knowledge and authoritarian hierarchies, which eventually disempower them. I then provide an explanation of this dualism by underlining the unique reality of China in terms of the co-existence of Western scientific medicine (WSM) and traditional Chinese medicine (TCM) and doctor-patient hierarchies. Finally, I outline the implications of this positioning for cancer care and discuss possible solutions drawing on recent humanistic models from the West.