Knowledge and identity construction in medical weblogs: A study of epistemic predicates

The social media, with their “unprecedented access to health information and medical records”, have the potential to facilitate clinical communication and healthcare, but at the same time they pose challenges for healthcare professionals1. Increased use of the social media has intensified the complexity of health communication: with new professional settings for the dissemination of medical knowledge, new multiple roles for both healthcare practitioners and non-experts have emerged and relationships between practitioners and patients have been re-negotiated. The reliability and objectivity of health information have become even more demanding ethical issues, so for health professionals it is more


Introduction
The social media, with their "unprecedented access to health information and medical records", have the potential to facilitate clinical communication and healthcare, but at the same time they pose challenges for healthcare professionals 1 .Increased use of the social media has intensified the complexity of health communication: with new professional settings for the dissemination of medical knowledge, new multiple roles for both healthcare practitioners and non-experts have emerged and relationships between practitioners and patients have been re-negotiated.The reliability and objectivity of health information have become even more demanding ethical issues, so for health professionals it is more 1 Prestin Abby, Chou S. Wen-Yying, "Web 2.0 and the changing health communication environment", in: The Routledge handbook of language and health communication, ed. by Heidi E. Hamilton, Wen-Yying S. Chou (New York: Routledge, 2014), 187; see also Kevin Harvey, Nelya Koteyko, Exploring health communication.Language in action (London-New York: Routledge, 2013); Stefania Maria Maci, Michele  Sala, Maurizio Gotti, "Introduction", in: Insights into medical communication, ed.Maurizio Gotti, Stefania  Maria Maci, Michele Sala (Bern: Peter Lang, 2015), 9-24.challenging to construct a trustworthy and authoritative persona.At the same time, lay recipients of information, patients or potential patients, are empowered not only to take more responsible decisions about their health but also to actively contribute to knowledge construction and sharing 2 .
Recent studies have shown 3 that medical weblogs, as a popular social media genre, play an important role in the exchange of medical knowledge in a similar way to other specialist weblogs 4 .In terms of structure, blogs are frequently updated web pages in which entries are displayed in reverse chronological order, and whose important element is the commenting facility.Like other social media, blogs are dynamic and multidirectional ecologies which enable information sharing, personal reflection and interaction with others 5 .To apply Herring et al.'s 6 early categorization of blogs, medical weblogs may be viewed as k(nowledge)-logs, that is environments for knowledge sharing, or according to more recent studies, thematic 7 or topic-oriented blogs 8 .
The role of blogging in the exchange and dissemination of knowledge has been confirmed by investigations into healthcare practitioners' motivations for blogging 9 .One of the dominant functions indicated by blogging healthcare practitioners is the popularization of science.The relevance of the popularization function is supported by such motivations provided by the bloggers as the stigmatization of pseudo-science, the popularization of knowledge based on facts, the development of healthy attitudes and the promotion of a healthy lifestyle.Another related motivation is the use of blogs for didactic purposes.Healthcare practitioners are interested in educating their diverse audience through a medium which can provide knowledge in an accessible way rather than 'from behind the desk'.
The objective of the present paper is to explore patterns of knowledge and identity construction in medical weblogs through a focus on epistemic predicates.The study follows interactional, discourse-based approaches to modality in which modality is viewed more broadly than a grammatical and semantic category.According to these approaches, modality as an important manifestation of subjectivity and evaluation relates to the expression of stance in discourse and plays a role in the construction of identity 10 .
In traditional grammar, modality is concerned with the status of a proposition which describes an event and refers to the expression of a speaker's attitude to the content of a proposition 11 .As a subcategory of modality, epistemic modality "expresses the degree of commitment of the speaker to the truth of what is being said" 12 , and epistemic verbs belong to the main exponents of epistemic modality 13 .Modal verbs have been argued to express interpersonal meanings 14 and their use is linked to the concepts of stance and evaluation 15 10 E.g.Elise Kärkkäinen, Epistemic stance in English conversation.A description of its interactional functions, with a focus on "I think" (Amsterdam-Philadelphia: John Benjamins, 2003); Juana I. Marín--Arrese, Laura Hidalgo Downing, Silvia Molina, "Evidential, epistemic and deontic modality in English and Spanish: The expression of writer stance in newspaper discourse", in: English modality in perspective: Genre analysis and contrastive studies, ed.Roberta Facchinetti, Frank Palmer (Frankfurt: Peter  Lang, 2004), 121-139; Robert Englebretson, ed., Stancetaking in discourse (Amsterdam-Philadelphia:  John Benjamins, 2007); Juana I. Marín-Arrese, "Effective vs. epistemic stance and subjectivity in political discourse: Legitimising strategies and mystification of responsibility", in: Critical discourse studies in context and cognition, ed.Christopher Hart (Amsterdam-Philadelphia: John Benjamins, 2011), 193-223;  eadem, "Stancetaking and inter/subjectivity in the Iraq Inquiry: Blair vs. Brown", in: English modality: Core, periphery and evidentiality, ed.Juana I. Marín-Arrese, et al. (Berlin: Mouton de Gruyter, 2013),  411-445; Roberta Facchinetti, "Modal verbs in news-related blogs: When the blogger counts", in: English modality: 359-377; Laura Hidalgo Downing, Begoña Núñez Perucha, "Modality and personal pronouns as indexical markers of stance: Intersubjective positioning and construction of public identity in media interviews", in: English modality, 379-410; Geoff Thompson, Laura Alba-Juez, eds., Evaluation in context (Amsterdam-Philadelphia: John Benjamins, 2014).and appraisal16 .For example, epistemic verbs can be considered as interpersonal metadiscourse 17 , as interactional metadiscursive resources 18 or as validity markers 19 .
The application of a broader, discourse-based approach to modality offers a way to study interpersonal meanings in text.For one thing, epistemic modality is socially and interactionally motivated and, as modal meanings are to some degree contextually determined, they may even acquire new interactive meanings and functions 20 .For another, exploring modality more broadly allows us to study speakers' attitudes and beliefs as well as their engagement with other voices and positions constructed in text 21 .Thus modality has relevance for the construction of identity in discourse, whereby identity is defined as a process of positioning of the self in relation to others 22 .Modality choices may be strategically used to negotiate speakers' identity positions in text, and so the focus on epistemic verbs may give us a possibility to investigate bloggers' and readers' positions in relation to the knowledge claims which they advance, to other voices constructed in text, and to their intended audience.
More generally, the approach adopted in the present paper aims to contribute to the study of knowledge and its relation to discourse, or to the advancement of discourse epistemics, that is, a multidisciplinary research domain which can give us insights into how knowledge is acquired and shaped by discourse, how it is presupposed, implied, expressed and shared 23 .What is of particular relevance for the aims of this paper is that both discourse and knowledge are "produced and understood under the control of context, defined as the subjective 'definition of the communicative situation', as it is represented by participants in dynamic context models" 24 .This implies that knowledge, and so the use of epistemically relevant expressions, should be studied as part of communicative situations; hence, the importance of the following social dimensions of context models: the setting, the roles and relations of participants, and the goals of the communicative event 25 .

Data and method
The research material for the present study consisted of 100 posts retrieved from the websites of ten blogs run in Polish by individual healthcare practitioners under their real names (five blogs) or anonymously (five blogs); for the complete list of blogs in the corpus, see Appendix.The bloggers represent the following specializations: ophthalmology, medical rescue, emergency cardiology, cardiology, stomatology, anesthesiology, optics and optometry, endocrinology and microbiology.The corpus includes both the posts and the accompanying comments.The bloggers differ in the frequency of updating their blogs: the data included in the corpus were submitted between January 2014 and December 2016, with the exception of one blog which had not been updated since 2013, so the data from this blog cover the period from February to October 2013.The research material is in Polish, but for the purposes of the present paper, I also provide an English translation of the examples26 .Following the guidelines for conducting research in web-mediated contexts27 , all of the bloggers were approached by email and gave their consent for the data to be used and quoted for the purposes of linguistic research 28 .
The theoretical-methodological background of the investigation draws on discourse approaches to modality, identity and knowledge.The analysis undertaken is essentially qualitative and the focus is put on the role of epistemic predicates in identity construction by the bloggers in the posts and comments, and by the blog's audience in the comments.Therefore, the research involved the search for the occurrences of epistemic verbs according to the list established on the basis of Danielewiczowa's 29 classification of Polish epistemic verbs of "insufficient knowledge", that is, verbs which are semantically founded on knowledge but which imply the lack of the epistemic subject's knowledge 30 .Danielewiczowa's study contributed to ample research in which modality, hedging and evidentiality are classi-fied according to function31 .Danielewiczowa grouped the epistemic verbs under investigation into the following categories: (1) myśleć, że 'think that' -grasping the ungraspable32 , (2) sądzić, że 'reckon that' -making epistemic judgments, (3) uważać, że 'be of the opinion that' -adopting a stance, (4) conjectures and doubts -two extremes of the epistemic scale, (5) helpful senses, or what it seems to somebody, (6) być pewnym, że 'be sure that' and być przekonanym, że 'be convinced that' -how much you lack in order to know and how important is justification, (7) belief and hope -a positive mindset, (8) suspicions and fears -a negative mindset, (9) delusions -contrary to what others may know, and (10) creating an epistemic reality.The verbs in focus are those denoting epistemic states, and as regards their surface structure, "they represent two-place predicates.The first argument refers to a personal epistemic subject.The other one takes the form of a subordinate clause; it is introduced by że 'that' in Polish" 33 .The search was supported by the use of the concordancing software Poliqarp (http://poliqarp.sourceforge.net/),a tool suitable for the analysis of languages rich in inflection.
The objectives of the research are: (1) to identify the epistemic verbs in use, (2) to explore the patterns of their use, and (3) to analyse their function in relation to identity work performed by the bloggers and their audience.It is assumed that the use of epistemic predicates will reflect: (1) the specificity of the communicative context of the medical weblog which merges informal interaction with more 'traditional' scientific communication; (2) the pursuit of the bloggers' professional and individual goals; (3) the patterns of bloggeraudience interaction.

Analysis and discussion
In what follows, I discuss the epistemic predicates identified in the data and the variety of their usage patterns according to the frequency of occurrence, however the frequency is not central to my discussion.Rather than focusing on the semantic analysis of the verbs in question, I explore the pragmatic effects of their use in the context of the medical weblog.

Helpful senses, or what it seems to somebody
This group includes verbs which express short-term, changeable epistemic states constructed on the basis of data received from the senses, that is, at least to some extent, the epistemic subject's direct perception is involved34 .It is the most frequent group in the corpus represented by mieć/odnosić wrażenie, że 'have/get the impression that' and wydaje się [komuś], że 'it seems [to sb] that'.Mieć/odnosić wrażenie, że 'have/get the impression that' indicates the uncertainty and subjectivism of the epistemic subject, but if compared with another verb in this group czuć, że 'feel that', they are more objective and social.They denote a temporary state which is, to some degree, constructed on the basis of shared knowledge35 .The occurrences of mieć/odnosić wrażenie, że 'have/get the impression that' in the corpus indicate respectively the blogger's -examples ( 1) and ( 2), or the reader's -examples (3) and ( 4), mitigated expression, coupled with a dose of irony about the functioning of the healthcare system in Poland, as in example (3).The verbs play a role in informal debate in which the blogger's or reader's view is expressed with distance but also engagement, as in (1), ( 2) and ( 4).
(1) Tymczasem czytając poszczególne pisma z uwagami odnoszę wrażenie, że prace nad nowelizacją ustawy sprowadzają się do zabójczej walki o interes nie pacjenta a własnych grup zawodowych36 .MB37 2 'Meanwhile, when reading particular documents with remarks, I get the impression that work on amendment of the act boils down to a deadly fight for the interest of own occupational groups rather than of patients'.
(2) Tak na szybko -mam wrażenie, że producent leku zrobił wszystko.aby nie mówić o jego podobieństwie do mifepristonu, a podobieństwo jest duże.MB8 'Briefly, I have the impression that the producer of the drug did everything not to tell about its similarity to mifepristone, and the similarity is big'.
(3) Reader's comment: Widzę, że problemy z drukarką są standardem :D czasem mam wrażenie, że przez nie wizyty trwają dwa razy dłużej :D MB5 'I can see that problems with a printer are a norm :D sometimes I have the impression that because of them, visits last twice as long :D' (4) Reader's comment: Mam jednak wrażenie, że w powyższym artykule niefortunnie dobrałeś piśmiennictwo.MB2 'I have the impression though that your choice of bibliography in the above article was unfortunate'.
The meaning of the verb wydaje się [komuś], że 'it seems [to sb] that' denotes the epistemic subject's awareness of his/her insufficient knowledge.It is thus close to suppose that and doubt that and refers to states which are weaker than belief and certainty.Its impersonal version wydaje się, że 'it seems that' has the value of such modal particles as probably, supposedly and so on 38 ; for an example, see (5).As a tentative expression, the verb is used to express low modality.Personal forms of the verb are frequently found in less formal debates held in comments sections.The blogger's reflection in (6) indicates her consideration of the audience and her engaged attitude in the discussion held in the comments section.Similarly, example (7) includes the blog follower's mitigated voice in the discussion inspired by the blog's topic.The uses of the verb wydaje się [komuś], że 'it seems [to sb] that' may result from the authors' consideration of politeness 39 , functioning as a face-saving strategy 40 .

Belief and hope: a positive mindset
The epistemic verbs of belief and hope presuppose positive valuation and thus their use indicates an axiological or volitive attitude of the epistemic subject41 .The group includes wierzyć, że 'believe that', mieć nadzieję, że 'hope that', liczyć [na to], że 'count that' and oczekiwać, że 'expect that'.As argued by Danielewiczowa42 , mieć nadzieję, że 'hope that' is a common verb which denotes an epistemic rather than an emotional state and the epistemic subject's strong engagement, but also his/her humility, recognition of insufficient knowledge and uncertainty about the state of affairs referred to in the complement clause, as, for example, in (8).However, in numerous cases in the data, the verb mieć nadzieję, że 'hope that' is used in more conversational, personal expressions as an attitude marker, for example, in ( 9) and ( 10).
(8) Mam nadzieje, że taki fundusz w końcu powstanie, a krytycy obecnej zdegenerowanej (według nich) koncepcji medycyny nie zawahają się, nie pójdą na kompromis, gremialnie zgłoszą tamże swój akces.MB8 'I hope that such a fund will be set up eventually, and the critics of the present, degenerate (in their opinion) conception of medicine will not hesitate, will not compromise, but will collectively declare their readiness to join this fund'.
Liczyć [na to], że 'count that' and oczekiwać, że 'expect that' do not have an axiological character and imply that the state of affairs referred to in the complement clause is barely advantageous for the epistemic subject and so the epistemic subject does not attach to this state any positive values 43 .Examples of the verbs' use in the research data give evidence of the bloggers' engagement in dialog with the audience and occur in informal, self-expressive posts (11) or comments (12).The epistemic verb wierzyć, że 'believe that' denotes the epistemic subject's belief which is clearly realized and which is in agreement with his/her system of knowledge and convictions 44 .Instances of wierzyć, że 'believe that' in the data are rare.Example (13) presents the blog follower's personal belief expressed as a parenthetical, digressive comment on the discussion on the necessity of vaccination against chicken-pox.

Myśleć, że 'think that'
The epistemic verb myśleć, że 'think that' is frequent, especially in spoken registers.It is semantically the most general and denotes the epistemic subject's knowledge, vaguely expressed, and readiness to express it 45 .It may also function as a face-saving strategy.The use of myśleć, że 'think that' in the corpus gives evidence for an informal, conversational style, where the bloggers as well as their readers are dynamically engaged in the explicit expression of their opinions, as in examples ( 14) to (18).This also shows that the process of thinking is an activity which directs attention both to the author and to the topic under discussion.The topics which generate intense discussions include the functioning of the healthcare system in Poland ( 14) and those considered to be controversial, such as vaccinations ( 16).The blog users readily shared their experience ( 17) and views about health communication online (15, 18).The verb myśleć, że 'think that' occurs mainly in the comments sections, which are more dialogic and spontaneous, see examples (15) to (18).( 14) Myślę, że czas na wznowienie pewnego wątku dyskusji na temat organizacji systemu ochrony zdrowia w Polsce.MB8 'I think that it is time to resume a certain thread of discussion on the organization of the health protection system in Poland'.
(15) Blogger's comment: pisałem kiedyś, czym jest dla mnie blog i myślę, że można to rozciągnąć na różnego typu fora i dyskusje pod informacjami czy artykułami w internecie.To taka wirtualna kafejka, do ktorej można wpaść i pogadać o tym, co wokoło.MB6 'I was once writing what a blog is for me and I think that this can be extended to various types of fora and discussions under news or articles in the internet.It [the blog] is such a virtual café, where you can pop in and chat about what is around'.
(16) Blogger's comment: I myślę, że tak to właśnie wyglądało, że szczepionka nie jest zbyt rokująca.Stąd nie zrobiono kolejnej fazy badań klinicznych i nie dopuszczono jej do użytku.MB10 'And I think that it looked just like that, that the vaccine was not too promising.That is why no further phase of clinical research was performed and the vaccine's use wasn't approved'.

Uważać, że 'be of the opinion that'
When using the interpretative verb uważać, że 'be of the opinion that', the epistemic subject takes a stance, often in a radical but responsible way, with the awareness that although the stance taken represents a subjective view of the world, it is well-grounded46 .Occurrences of uważać, że 'be of the opinion that' used in the first-person singular indicate the bloggers' responsibility and confidence.In this way they legitimize the health practitioners' professional identity, as public members of society who are concerned with more general issues, as in (19), and as specialists offering their competent advice, as in (20).The audience supports the bloggers with their voices in the discussion, for instance aiming to dispel popular health myths, as in (22).The bloggers and readers present their opinion while respectfully acknowledging the space for other, alternative voices, as in (19), (20) and (22).The verb may also be used impersonally, like in more 'traditional' forms of scientific communication, as in (21).
(25) Z powodu podobieństw w funkcjonowaniu mózgów u wszystkich zwierząt, są podstawy sądzić, że i u nas proces zachodzi w ten sam sposób.MB9 'Because of the similarities in how the brain functions in all animals, there is a basis for reckoning that also in us the process occurs in the same way'.
3.6.Być przekonanym, że 'be convinced that' Być przekonanym, że 'be convinced that' is a strong epistemic verb used for persuasive purposes.It implies that the epistemic subject managed to overcome doubts by finding good justification.Although its use is subjective, conviction is built not only on the basis of particular knowledge about a given state of affairs, but also on more general knowledge49 .In the corpus, the bloggers take an authoritative position in making a claim: about the reforms in the healthcare system, as in ( 26), or in scientific discussions of medical issues, as in ( 27).The use of być przekonanym, że 'be convinced that' in example ( 27) additionally supports the popularization function of blogs.Example (28) illustrates the use of the verb in a more private context, where the blogger engages in a personal narration to entertain the audience.Such elements of self-expression and self-disclosure characteristic to blog discourse serve to diminish the distance between bloggers and their diverse audiences.
(27) Jestem przekonany, że każda ze skomplikowanych relacji pomiędzy substancjami regulacyjnymi w organizmie ma głęboki sens ewolucyjny ustalony podczas doskonalenia się do przetrwania w niesprzyjającym środowisku.MB9 'I am convinced that each of the complicated relations between regulatory substances in the organism has a deep evolutionary sense that was established while improving to survive in an unfavorable environment'.

Suspicions and fears: a negative mindset
Podejrzewać, że 'suspect that' and obawiać się, że 'fear that' represent the epistemic verbs which presuppose negative valuation of the state of affairs referred to in the complement clause, as states which are negative or unwelcomed by the epistemic subject.Specifically, podejrzewać, że 'suspect that' is in opposition to belief, and obawiać się, że 'fear that' is in opposition to hope 50 .The use of these verbs gives evidence of the subject's (emotional) engagement and is potentially face-threatening.Example (29) includes a reader's comment on a post on the ambiguities of newspeak used by companies to deliberately mislead customers.In the post, the blogger mocks this use of newspeak, and by means of expressive, ironic language and rhetorical questions, enacts a conversation with the audience.In reply, the commenter attempts to speculate about the meaning of the ambiguous sentence quoted from the post.Example (30) comes from the introductory part of the post about the tetanus vaccines.The blogger is critical of anti-vaccination attitudes.The use of obawiać się, że 'fear that' in the first-person singular in combination with a colorful (and difficult to render in translation) expression (for example, "fajerwerki pomysłów" 'fireworks of ideas', idiomatic "z cicha pęk" 'out of the blue', or ironic "wydumanych niebezpieczeństw" 'airy-fairy threats') serve to arouse the audience's interest in the post's topic.
(30) Nie żebym czekała na jakieś fajerwerki pomysłów -obawiam się, że mimo iż ludzka pomysłowość często nie ma granic, a ludzie bywają z cicha pęk i w rzeczy samej nadzwyczaj zmyślni, to akurat w wypadku szczepionek lista wydumanych niebezpieczeństw jest jednak skończona.MB10 'It is not that I'm waiting for some fireworks of ideas -I fear that despite the fact that human resourcefulness often has no limits, and people can be, out of the blue and indeed, extraordinarily clever, in case of vaccinations, the list of airy-fairy threats is finite'.

Summary and conclusions
In summary, the variety of the usage patterns of epistemic verbs in the research data reveals the roles which healthcare practitioners act out in their blogs and the purposes for which they engage in blogging.The epistemic verbs in focus are used to express engagement in current public life, especially in the functioning of the healthcare system in Poland; to report on (new) medical discoveries and to evaluate them; to debate and argue; to present a structured reasoning; to show awareness of the blog's diverse audiences and to minimize the distance between them.
To construct their professional identity, the healthcare practitioners draw on discursive strategies of distancing-mitigation (cf. the use of mieć/odnosić wrażenie, że 'have/get the impression that', wydaje się [komuś], że 'it seems [to sb] that', podejrzewać, że 'suspect that' and obawiać się, że 'fear that'), legitimization (cf. the use of myśleć, że 'think that', uważać, że 'be of the opinion that', sądzić, że 'reckon that', być przekonanym, że 'be convinced that') and self-disclosure (cf. the use of wierzyć, że 'believe that', mieć nadzieję, że 'hope that', liczyć [na to], że 'count that' and oczekiwać, że 'expect that', podejrzewać, że 'suspect that' and obawiać się, że 'fear that').The analysis of epistemic predicates demonstrates the healthcare practitioners' overlapping and shifting roles in the medical weblog: they position themselves as expert specialists who follow their professional ethos, as researchers who extend their knowledge, and advice givers who are willing to share knowledge with their non-specialist audience and to educate their patients.They authenticate their expertise through references to their own medical practice and experience.Healthcare practitioners' professional identity is often constructed around struggles to balance patients' expectations and the professional ethos attached to their roles, impeded by institutional barriers 51 .The bloggers also aim to minimize the distance between their audience, enact conversation with them and integrate a blogging community.In response, the audience actively participates in the co-construction of knowledge and experience-sharing, and thus contributes to community building.The commenters sometimes take a voice in a discussion with responsibility and confidence (cf. the use of uważać, że 'be of the opinion that'), and, perhaps more frequently, with a degree of mitigation (cf. the use of mieć/odnosić wrażenie, że 'have/get the impression that' or wydaje się [komuś], że 'it seems [to sb] that').It seems that the use of epistemic predicates by the audience confirms a more conversational, spontaneous and expressive style of interaction present in the comment section of the weblog (cf. the use of wierzyć, że 'believe that', myśleć, że 'think that', or podejrzewać, że 'suspect that').
In general, this study appears to prove that healthcare practitioners treat their online identity in the weblog, regardless of whether it is anonymous or not, as an extension of their 51 Agnieszka Sowińska, "'Even if there were procedures, we will be acting at our own discretion...' General practitioners' struggle about identity", in: Identity struggle: Evidence from workplaces across the world, ed.Dorien Van Den Mieroop, Stephanie Schnurr (Amsterdam-Philadelphia: John Benjamins, 2017), 281-298.offline professional self, crafted carefully in order to maintain their good reputation in the evolving context of the social media, where the blogs' followers play an important role.The institutional and private, self-disclosive aspects of identity intertwine in medical blogs, which results from their inherent technological features.Further investigations are needed which can take into consideration specialization-, status-and genre-dependent use of epistemically relevant expressions in the challenging contexts of health communication online.

Knowledge and identity construction in medical weblogs:
A study of epistemic predicates S u m m a r y Following the discourse-based, interactional approaches to modality and identity, and recognizing that knowledge is social, relative and contextual, this paper aims to explore epistemic predicates in a corpus of Polish medical weblogs run by healthcare practitioners.The focus is put on the role of epistemic predicates in identity work performed by the bloggers and their audience.The study reveals the variety of the usage patterns of epistemic verbs, the diversity of the roles which healthcare practitioners act out in their blogs and the numerous purposes for which they engage in blogging.To construct their professional identity, healthcare practitioners draw on discursive strategies of distancing-mitigation, legitimization and self-disclosure.In this way, they position themselves as expert specialists who follow their professional ethos, as researchers who extend their knowledge and advice givers who are willing to share knowledge with their non-specialist audience and to educate their patients.They authenticate their expertise through references to their own medical practice and experience.The bloggers also aim to minimize the distance between their readers and engage in conversation with them.In response, the audience actively participates in the co-construction of knowledge and experience-sharing, and contributes to community building.