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Background: In recent years, paid online patient-physician interaction has been incorporated into the telemedicine markets. With the development of telemedicine and telemedicine services, online feedback has been widely applied, helping other patients to identify quality services. Recently, in China, a new type of service feedback has been applied to the telemedicine markets, namely, paid feedback. Patients who are satisfied with a physician's online service can buy a virtual gift or give a tip to the physicians. This paid feedback can improve the reliability of service feedback and reduce the proportion of false information because it increases the cost for feedback providers. Paid online feedback can benefit the physicians, such as by providing them with monetary incentives; however, research on the impacts and value of such paid feedback from the physician perspective in the telemedicine markets is scant. To fill this research gap, this study was designed to understand the role of paid feedback by developing a research model based on the theories of signaling and self-determination., Objective: This study aimed to explore the effects of free and paid feedback on patients' choice and physicians' behaviors as well as to investigate the substitute relationship between these 2 types of feedback in the telemedicine markets., Methods: A JAVA software program was used to collect online patient-doctor interaction data over a 6-month period from a popular telemedicine market in China (Good Physician Online). This study drew on a 2-equation panel model to test the hypotheses. Both fixed and random effect models were used to estimate the combined effects of paid feedback and free feedback on patients' choice and physicians' contribution. Finally, the Hausman test was adopted to investigate which model is better to explain our empirical results., Results: The results of this study show that paid feedback has a stronger effect on patients' choice (a 5 =0.566; t 2192 =9.160; P<.001) and physicians' contribution (β 4 =1.332; t 2193 =11.067; P<.001) in telemedicine markets than free feedback. Moreover, our research also proves that paid feedback and free feedback have a substitute relationship in determining patients' and physicians' behaviors (a 6 =-0.304; t 2191 =-5.805; P<.001 and β 5 =-0.823; t 2192 =-8.136; P<.001)., Conclusions: Our findings contribute to the extant literature on service feedback in the telemedicine markets and provide insight for relevant stakeholders into how to design an effective feedback mechanism to improve patients' service experience and physicians' engagement., (©Hualong Yang, Xiaofei Zhang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.03.2019.)

Purpose: Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information is still unknown. This study used the signaling theory to examine the substitute relationship between professional status and service feedback in patients' doctor choice, as well as the moderating effect of illness severity. Design/methodology/approach: To test the paper's hypotheses, we constructed a panel data model using 418 doctors' data collected over a period of six months from an online healthcare market in China. Then, according to the results of the Hausman test, we estimated a fixed-effects model of patients' choice in online healthcare markets. Findings: The empirical results showed that the effect of a doctor's professional status and service feedback on a patient's doctor choice was substitutable. Moreover, patients' illness severity played a moderating role, in that the influence of professional status on a patient with high-severity illness was higher than that on a patient with low-severity illness, whereas the influence of service feedback on a patient with low-severity illness was higher than that of a patient with high-severity illness. In addition, we found that illness severity negatively moderated the substitute relationship between professional status and service feedback on a patient's choice. Originality/value: These findings not only contribute to signaling theory and research on online healthcare markets, but also help us understand the importance of professional status and service feedback on a patient's choice when seeking a doctor online. [ABSTRACT FROM AUTHOR]

With the development of e-health, the number of doctors providing consultation services in online healthcare communities (OHCs) is growing. Their aim is to help patients obtain healthcare information and treatment. Since the doctors' contributions are essential to a sustainable development of OHCs, understanding why doctors contribute to OHCs is crucial. However, the related literature that investigate motivators of doctors' contribution behaviours in OHCs is scant. OHCs are a type of novel online community through which doctors not only obtain personal compensation but also interact with patients to build their relationship network. Hence, both personal and social motivators may affect doctors' contributions to OHCs. Based on the theories of self-determination and Maslow's hierarchy of needs, we established an empirical model to explore the effects of reputation, monetary rewards, doctor–patient interaction and professional status. The empirical results show that both personal and social motivators have positive effects on doctors' contributions to OHCs, and that doctors' professional status has a moderating effect. These findings help us understand the motivational mechanisms of doctors' contributions to OHCs. [ABSTRACT FROM AUTHOR]