JMIR Publications

ABSTRACT

Background:

Web-based healthcare has the potential to improve healthcare access and convenience for patients with limited mobility, but its success depends on active physician participation. The economic return of internet-based healthcare initiatives is an important factor that can motivate physicians to continue their participation. While several studies have examined the communication patterns and influences of online health consultations, the correlation between physicians’ communication characteristics and their economic return remains unexplored.

Objective:

This study aimed to investigate how the linguistic features of two modes of physician-patient communication, instrumental and affective, determine the physician’s economic returns measured by the honorarium their patients agree to pay per consultation. We also examined the moderating effects of communication media (text and voice messages) and the compounding effects of different communication features on economic returns.

Methods:

We collected 40,564 online consultations from 528 physicians across four disease specialties on a large web-based healthcare platform in China. Communication features were extracted using linguistic inquiry and word count, and we used multivariable linear regression and K-means clustering to analyze the data.

Results:

We found that the use of cognitive processing language (i.e., insight, causation, tentativeness, and certainty-related words) in instrumental communication and positive emotion-related words in affective communication were positively associated with the economic returns of physicians. However, the extensive use of discrepant-related words could generate adverse effects. We also found that the use of voice messages for service delivery magnified the effects of cognitive processing language but did not moderate the effects of affective processing language. The highest economic returns were associated with consultations in which physicians used fewer expressions related to negative emotion, more terms associated with positive emotions, and later employed instrumental communication language.

Conclusions:

Our study provides empirical evidence of the relationship between physicians’ communication characteristics and their economic returns. It contributes to a better understanding of patient-physician interactions from a professional-client perspective and provides practical implications for physicians and web-based healthcare platform executives.