Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Aug 19, 2022)
Date Submitted: Dec 19, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Offline Reputation Matters: Physicians’ Online Reputation Bias in Online Health Communities
ABSTRACT
Background:
Online health communities (OHCs) have gradually become an important service platform for patients to communicate with physicians and obtain treatment and related medical information. With the rise of OHCs, an increasing number of scholars have begun to study the incentive mechanism of a physician’s online contribution behavior. However, previous studies have ignored the limited effect of online reputation on a physician’s online contribution and the moderating effect of offline reputation.
Objective:
We hypothesized that online reputation shows an inverted U-shaped relation with a physician’s contribution and that offline reputation reduces the inverted U-shaped relation, thus weakening the positive impact of reputation on performance and strengthening the negative impact of reputation performance.
Methods:
Based on incentive theory and prior studies, we proposed three hypotheses. We collected the panel data of 6,648 physicians from Good Physician, one of the largest OHCs in China. An empirical model was built to test our hypotheses. Additionally, the variables representing online reputation were replaced and the data set was split for the robustness check.
Results:
First, our results support the hypothesis of an inverted U-shaped relationship between a physician’s online reputation and their online contribution behavior(β=-0.127, t=13.624, P<.001). Second, we identify the bipolar impact of online and offline reputation on a physician’s online contribution. Specifically, over a period of time, online reputation will promote the contribution of physicians(slope=1.514, P<.001), while offline reputation will inhibit the contribution. Third, our research shows that offline reputation can weaken the impact of online reputation on a physician’s online contribution.
Conclusions:
We amended the bias of the positive linear correlation between online reputations and online contributions in OHCs. Moreover, by identifying the moderating effect of offline reputation, we ameliorated the interpreting mechanism of online reputation on a physician’s online contribution. The findings improve our understanding of physicians' online contribution behaviors and contribute to the literature on OHCs. Our research can provide guidance for an OHC to design effective personalized incentive mechanisms and encourage physicians to provide more high-quality services.
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