Online discussion forums for patients offer the benefits of community but the risks of misinformation. A physician-moderated forum may help to mitigate this tension. How do both the professional expertise of a physician moderator and the personal, experiential expertise of patients contribute to trust in a forum? A rhetorical analysis of a year of postings in an online Parkinson’s community reveals that both forms of expertise were trusted, demonstrating the possibility for them to complement each other. This study illustrates the broader ways trust is established in patient communities and offers implications for technical communicators as forum designers or moderators.

This article explores rhetorical implications of extending the audience of written physician notes in hospital settings to include patients and/or family members (the OpenNotes program). Interviews of participating hospital patients and family members (n = 16) underscored the need for more complex understandings of audience beyond “universal” and “particular” explanations. Interviews were organized around the aspects of comprehension, affect/emotion, and likes/dislikes about receiving notes. Results from these interviews indicated that participants understood the notes overall but had questions about abbreviations and technical terms. Many participants felt reassured about the care they were receiving, and many liked having the notes as a reference and springboard for further discussion with health care staff. A more detailed content analysis of the interview data yielded themes of document use, readability, involvement, and physician care. Findings from this study reveal an expansion of audience in this case to include both universal and particular audiences. Also, findings point to the possibility of audience involvement among patients and family members through activities such as asking questions about the physician notes. This study has implications for other forms of written communication that may extend readership in novel ways.