Knowledge, Evidence, Expertise? The Epistemics of Experience in Contemporary Healthcare

This paper explores how personal experience acquires the status of knowledge and/or evidence in contemporary healthcare contexts that emphasise being both patient-centred and evidence-based. Drawing on a comparative analysis of three case studies -- self-help and mutual aid groups; online patient activism; and patient feedback in healthcare service delivery -- we foreground: (a) the role that different technologies and temporalities play in how experience is turned (or fails to be turned) into knowledge or evidence; (b) the role that experts-"of"-experience, in addition to the more frequently referenced experts-"by"-experience, play in mediating how, when and why experience is turned into an epistemic resource; and finally, (c) how the need to be 'evidence-based' remains a persistent, yet at times productive, challenge to how patient and user experiences are incorporated in contemporary healthcare policy and practice. Throughout the paper, we argue that it is necessary to look at both democratic and epistemic imperatives for including patient and service users in healthcare services and policymaking based on their experience.