JMIR Publications

ABSTRACT

Background:

Online health platforms are currently experiencing significant growth. It is imperative to bolster patients' trust in the platform while also enhancing their overall online experiences and the efficiency of physician-patient communication. A greater emphasis is placed on physicians' communication strategies during online physician-patient interactions.

Objective:

The study aims to explore the relationship between discourse strategies of physicians and online patient consultation behavior in online physician-patient interactions. Additionally, we explore the crucial roles of online physician-patient trust and shared decision-making in this process.

Methods:

Data on physician basic attributes and physician-patient interaction texts were collected from the Chunyu Doctor website using a web spider. The study obtained a total of 8628 interaction texts and 863 physicians' basic attribute data from January 2022 to July 2023. The physician discourse strategies related variables (capacity-oriented strategy, quality-oriented strategy, and goodwill-oriented strategy), online physician-patient trust, and shared decision-making were measured through text mining and random forest. The study generated 863 groups of data with 17 data fields. The hypotheses were tested using an OLS model and the stability test was conducted by replacing the dependent variable.

Results:

The hypothetical model results indicate statistically significant correlations between quality-oriented strategy and patient consultation behavior. The capacity-oriented strategy has a positive significant effect (β=0.151, p<0.05), as well as the goodwill-oriented strategy (β=0.154, p<0.05), and the quality-oriented strategy (β=0.17, p=<0.05). Online physician-patient trust plays a mediating role between physician discourse strategies and patient consultation behavior. Physician notification adequacy from shared decision-making moderates the effect between goodwill-oriented strategy and patient consultation behavior, while patient expression adequacy from shared decision-making moderates the effect between the capacity-oriented strategy and patient consultation behavior, as well as between goodwill-oriented strategy and patient consultation behavior.

Conclusions:

The correlations suggest significant implications for stimulating patient consultation behavior on online health platforms by providing guidance on effective discourse strategies for physicians, thus constructing a trustworthy physician image and increasing platform traffic.