Join or not: The impact of physicians’ group joining behavior on their online demand and reputation in online health communities

https://doi.org/10.1016/j.ipm.2021.102634Get rights and content

Highlights

  • Individual group joining behavior positively affects individual online demand and reputation.

  • The higher person-group fit, the better individual online demand and reputation in online health communities.

  • Physicians’ title negatively moderates the relationship between individual group joining behavior and their online demand.

Abstract

Group service in online health communities (OHCs) is a novel form of service where physicians can share knowledge and collaborate with others to provide better services to patients through the Internet. Although many literatures have explored the impact of individual group joining behavior on group performance, few researches have been done on the relationship between individual group joining behavior and their personal performance. To fill this gap, we examine the effect of individual group joining behavior on their online demand and reputation using a unique panel dataset of 8,069 physicians from a large online health community in China. In addition, how the effects differ among physicians with different clinic titles are explored and several robustness checks including propensity score matching analyses are conducted to control for self-selection among physicians. The results show that, physicians’ group joining behavior and the person-group fit will positively affect their online demand and reputation. Furthermore, we find that physicians’ clinic title has a negative moderating effect.

Introduction

Online health communities (OHCs), such as Med help, Doximity, Haodaifu, and Guahao have become increasingly popular (Alemu & Huang, 2020; Jie, Gao & Agarwal, 2016). These communities have gathered millions of users and shared valuable health information (Zhao, Fu & Chen, 2020). Users can search for health knowledge, consult health problems and share their experience in OHCs (Yan, Wang, Chen & Zhang, 2016). In the United States, about 90% of the population use the Internet to seek for health-related information online (Pluye et al., 2019). In China, 80% patients search on the internet for information related to their illness before going to the hospital for treatment (Wu & Lu, 2017). Obviously, OHCs are favored by physicians and patients and are becoming important platforms for health service providing (Yan & Tan, 2014). And OHCs can establish an effective service channel between physicians and patients (Chen, Guo, Wu & Ju, 2020). In OHCs, physicians can provide health services to patients and patients can handle their health problems online (Fichman, Kohli & Krishnan, 2011; Zhao, Da & Yan, 2021). In order to attract physicians and patients to participate and stay in the community, OHCs launch multiple health service modes, which usually include text consultation, telephone consultation, outpatient appointment and article posting. These different types of service modes enable physicians to provide health service according to patients’ personalized needs.

Group service is one of the most distinctive modes that emerged recently in online physician-to-patient communities. It enables physicians to form or join an online group composed of other physicians who are from different regions, hospitals and departments. Members in online groups can collaborate and provide health services to patients. Therefore, we define the behavior of physicians joining an online health group as group joining behavior. By joining online groups, physicians can build close ties with other physicians in the group. Physicians can discuss with and consult other group members about treatment options for diseases, which continuously improve their professional skills and service quality (Wu & Deng, 2019). Physicians in the same online group collaborate with each other to provide health services, and patients can select an appropriate online group to consult. When physicians join the OHCs, they can decide whether to join in a group or not, and they can also choose which group to join in. If physicians join a group, they can be browsed and consulted not only through their personal webpage, but also through the group's. Moreover, when a physician decides to join an online group, he/she has to choose an appropriate group, which can help to achieve his/her goal. Person-group fit is defined as the compatibility between people and the group they joined, and can be used to evaluate whether the group that the physician joined is appropriate or not (Kristofbrown, Zimmerman & Johnson, 2005).

Although significant progress has been made in group work, evidence of group work effects on individuals remains mixed. Sanyal and Hisam examined the impact of group work on occupational performance, and found that there is a strong and positively significant connection between group work and individuals (Sanyal & Hisam, 2018). However, other literature showed that group work has a negative effect on individuals. Soraperra et al. conducted an experimental study to test the consequences of group work. They found that individuals are rather dishonest when working on group work, and group work negatively affect individuals (Soraperra et al., 2017). Online physician groups play an important role in health markets as a new channel for physicians to collaborate and share knowledge. Discussions among physicians help decrease uncertainty and thus improve physicians’ service quality (Wu & Deng, 2019). However, few studies explored the effect of individual group joining behavior.

To fill this gap, our study draws insights from social learning theory and the homophily and examine the effect of individual group joining behavior from a new perspective. First, we discuss the learning process of physicians in online group, and this learning process is rooted in social learning theory, which assumes that individuals often learn by observing others, and emphasizes the interaction between individuals and their environment.

When physicians join an online group, they can communicate with and learn from other group members by observing members’ online diagnosis and treatment behavior. This learning process will usually help to improve physicians’ overall capability. Moreover, physicians’ overall capability has an impact on their online demand or reputation. Therefore, we investigate whether physicians’ group joining behavior influence their online demand and reputation. Second, we also look at the role of homophily, measured by person-group fit, in individuals joining groups. We examine how physicians’ person-group fit influences their online demand and reputation. Third, we investigate the moderating effects of physicians’ title on the relationships between physicians’ group joining behavior and their online demand and reputation.

The rest of the paper consists of the following parts. First, we review the relevant literature streams and theoretical foundation. Then we develop research hypotheses. This is followed by research context, datasets, measurement, data analysis, results and robustness checks. Finally, the discussion part is presented, followed by conclusions.

Section snippets

Theoretical background

This study uses the social learning theory and homophily to examine the influence of both group joining behavior and person-group fit on online demand and reputation in OHCs. Existing literature find that integration of theories can help to provide a broader understanding of individual behavior (Shuk Ying & Bodoff, 2014; Yongqiang, Nan, Xitong & Zeyu, 2013). The homophily focuses on the similarity between individuals and group mates and the influence of this similarity on individuals (

Research model

Based on social learning theory and homophily literature, we propose the following research framework in OHCs (Fig. 1). We hypothesize that individual group joining behavior and person-group fit significantly affect individual online demand and reputation, and physicians’ title moderate these relationships.

Research context and data collection

Online group service from Guahao (https://www.guahao.com), an OHC platform, were selected to test the research hypotheses. Guahao provides health services and knowledge sharing for physicians and patients in China. At present, the website includes more than 240,000 physicians from 2700 hospitals in 30 provinces. The number of registered patients exceeds 160 million.

The online group services are launched to provide patients with better health services. Normally, as shown in Fig. 2, groups are

Key findings

Given the fierce competition among online health service platforms, OHCs take a series of measures to attract physicians such as launching the online group service.

Our study investigates the impact of the group joining behavior on individual online consultation and reputation. Specifically, we examine the effect of physicians’ person-group fit on individual online consultation and reputation. Methodologically, our study uses the unbalanced panel data and fixed effects model for estimations. To

Conclusion

Online group service plays an important role in improving the comprehensive and competitiveness of physician-to-patient communities in health market. However, significant voids remain in our understanding of the impact of physicians’ individual group joining behavior on individual characteristics. Thus, this study has examined the impact of physician group joining behavior, person-group fit on physicians’ online demand and reputation in physician-to-patient communities. We developed a research

CRediT authorship contribution statement

Wanxin Qiao: Data curation, Formal analysis, Investigation, Methodology, Writing - original draft. Zhijun Yan: Conceptualization, Funding acquisition, Investigation, Supervision, Writing - review & editing. Xiaohan Wang: Writing - original draft.

Acknowledgments

This work was supported by the National Key Research and Development Plan of China (Grant No: 2017YFB1400101), the National Natural Science Foundation of China (Grant No: 71872013, 71572013, 71602009, 72072011), and the Beijing Municipal Social Science Foundation (Grant No: 18JDGLB040).

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