Patient Expertise and Medical Authority: Epistemic Implications for the Provider-Patient Relationship.

Abstract

The provider-patient relationship is typically regarded as an expert-to-novice relationship, and with good reason. Providers have extensive education and experience that have developed in them the competence to treat conditions better and with fewer harms than anyone else. However, some researchers argue that many patients with long-term conditions (LTCs), such as arthritis and chronic pain, have become "experts" at managing their LTC. Unfortunately, there is no generally agreed-upon conception of "patient expertise" or what it implies for the provider-patient relationship. I review three prominent accounts of patient expertise and argue that all face serious objections. I contend, however, that a plausible account of patient expertise is available and that it provides a framework both for further empirical studies and for enhancing the provider-patient relationship.