Doctor–patient relationship strength’s impact in an online healthcare community

ABSTRACT Doctor–patient (D–P) interaction currently faces a set of challenges owing to a dearth in medical resources and related communication reasons. Healthcare information technology and associated systems, such as those supporting online healthcare communities (OHCs) that provide new platforms for information exchange and online communication, are expected to alter traditional D–P relationship models. Despite significant results from extant research indicating patient benefits, empirical research on OHC returns for physicians is lacking. This exploratory study examines the strength of the D–P relationship and its impacts on physicians’ individual outcomes in an OHC. Guided by the social capital and social ties theories, and using a structural equation modeling (SEM) approach to study 339,010 instances of doctor–patient communication from 1430 physicians at The Good Doctor (www.Haodf.com), which is one of the largest Chinese OHCs, we found that weak ties can result in economic and social returns for doctors. However, further analysis has indicated that strong ties mediate the effect of weak ties, thus encouraging doctors to convert weak ties into strong ties by mobilizing their website settings to strengthen their relationships and, subsequently, to be better rewarded. Implications for research and practice on the development of healthcare information technology and associated systems are discussed.

[1]  N. Lin,et al.  Social Resources and Strength of Ties: Structural Factors in Occupational Status Attainment , 1981, Social Capital, Social Support and Stratification.

[2]  Sharon J. McLennan.  Techno-optimism or Information Imperialism: Paradoxes in Online Networking, Social Media and Development , 2016, Inf. Technol. Dev..

[3]  Robert E. Kraut,et al.  The Relationship between Facebook Use and Well-Being depends on Communication Type and Tie Strength , 2016, J. Comput. Mediat. Commun..

[4]  Helena Barnard,et al.  TIE BREADTH, TIE STRENGTH AND THE LOCATION OF TIES: THE VALUE OF TIES INSIDE AN EMERGING MNC TO TEAM INNOVATION , 2016 .

[5]  Ritu Agarwal,et al.  The Creation of Social Value: Can an Online Health Community Reduce Rural-Urban Health Disparities? , 2016, MIS Q..

[6]  Ritu Agarwal,et al.  Vocal Minority and Silent Majority: How Do Online Ratings Reflect Population Perceptions of Quality? , 2015, MIS Q..

[7]  Yong Tan,et al.  Feeling Blue? Go Online: An Empirical Study of Social Support among Patients , 2014, Inf. Syst. Res..

[8]  Robert E. Kraut,et al.  Growing closer on facebook: changes in tie strength through social network site use , 2014, CHI.

[9]  Paul Michael Di Gangi,et al.  Online health communities: An assessment of the influence of participation on patient empowerment outcomes , 2013, Inf. Technol. People.

[10]  Ricardo Gomez,et al.  Relationships and Connectedness: Weak Ties that Help Social Inclusion Through Public Access Computing , 2013, Inf. Technol. Dev..

[11]  Terence T. Ow,et al.  Examining the impact of information technology and patient flow on healthcare performance: A Theory of Swift and Even Flow (TSEF) perspective , 2013 .

[12]  B. Kirkwood,et al.  Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review , 2013, Journal of medical Internet research.

[13]  Lada A. Adamic,et al.  The role of social networks in information diffusion , 2012, WWW.

[14]  Angelika Dimoka,et al.  On Product Uncertainty in Online Markets: Theory and Evidence , 2011, MIS Q..

[15]  Moira Burke.  Reading, Writing, Relationships: The Impact of Social Network Sites on Relationships and Well-Being , 2011 .

[16]  Corey M. Angst,et al.  Doctors’ orders––If they’re electronic, do they improve patient satisfaction? A complements/substitutes perspective , 2011 .

[17]  Pankaj Setia,et al.  The Effects of the Assimilation and Use of IT Applications on Financial Performance in Healthcare Organizations , 2011, J. Assoc. Inf. Syst..

[18]  D. A. Kenny,et al.  Interpersonal perception in the context of doctor-patient relationships: a dyadic analysis of doctor-patient communication. , 2010, Social science & medicine.

[19]  Eric Gilbert,et al.  Predicting tie strength with social media , 2009, CHI.

[20]  Gerard Delanty.  The Foundations of Social Theory , 2009 .

[21]  C. Dube,et al.  Untangling the Web--the impact of Internet use on health care and the physician-patient relationship. , 2007, Patient education and counseling.

[22]  Christopher E. Beaudoin,et al.  Benefiting from Social Capital in Online Support Groups: An Empirical Study of Cancer Patients , 2007, Cyberpsychology Behav. Soc. Netw..

[23]  Cliff Lampe,et al.  The Benefits of Facebook "Friends: " Social Capital and College Students' Use of Online Social Network Sites , 2007, J. Comput. Mediat. Commun..

[24]  K. G. J8reskoC,et al.  Simultaneous Factor Analysis in Several Populations , 2007 .

[25]  P. Kummervold,et al.  Patients Who Use E-Mediated Communication With Their Doctor: New Constructions of Trust in the Patient-Doctor Relationship , 2006, Qualitative health research.

[26]  Mark E. J. Newman,et al.  Structure and Dynamics of Networks , 2009 .

[27]  Tamás Nepusz,et al.  Measuring tie-strength in virtual social networks , 2006 .

[28]  Nicolas Poussing,et al.  Internet Use and Social Capital: The Strength of Virtual Ties , 2010 .

[29]  Samer Faraj,et al.  Why Should I Share? Examining Social Capital and Knowledge Contribution in Electronic Networks of Practice , 2005, MIS Q..

[30]  Ronald M Epstein,et al.  Assessing communication competence: a review of current tools. , 2005, Family medicine.

[31]  Mark S. Granovetter.  The Impact of Social Structure on Economic Outcomes Social Networks and Economic Outcomes: Core Principles , 2022 .

[32]  S M Akerkar,et al.  Doctor patient relationship: changing dynamics in the information age. , 2004, Journal of postgraduate medicine.

[33]  J. Powell,et al.  Primary care Health related virtual communities and electronic support groups : systematic review of the effects of online peer to peer interactions , 2004 .

[34]  L. Baker,et al.  Use of the Internet and e-mail for health care information: results from a national survey. , 2003, JAMA.

[35]  Caroline Haythornthwaite,et al.  Strong, Weak, and Latent Ties and the Impact of New Media , 2002, Inf. Soc..

[36]  Peter T. Ward,et al.  The effect of location, strategy, and operations technology on hospital performance , 2002 .

[37]  P. Resnick.  Beyond Bowling Together: SocioTechnical Capital , 2001 .

[38]  E. Glaeser,et al.  An Economic Approach to Social Capital , 2000 .

[39]  Nan Lin,et al.  SOCIAL NETWORKS AND STATUS ATTAINMENT , 1999 .

[40]  N. Lin.  Buidling a Network Theory of Social Capital , 1999, Connections.

[41]  Rebecca L. Sandefur,et al.  A PARADIGM FOR SOCIAL CAPITAL , 1998 .

[42]  M. Stewart,et al.  Patient-physician communication assessment instruments: 1986 to 1996 in review. , 1998, Patient education and counseling.

[43]  D. Morales-gomez,et al.  Utilising information and communication technologies for development: the social dimensions , 1998 .

[44]  S. Ghoshal,et al.  Social Capital, Intellectual Capital, and the Organizational Advantage , 1998 .

[45]  Y. Bian.  Bringing strong ties back in: Indirect ties, network bridges, and job searches in China , 1997 .

[46]  B. Uzzi,et al.  Social Structure and Competition in Interfirm Networks: The Paradox of Embeddedness , 1997 .

[47]  G. Makoul,et al.  Health promotion in primary care: physician-patient communication and decision making about prescription medications. , 1995, Social science & medicine.

[48]  J. de Haes,et al.  Doctor-patient communication: a review of the literature. , 1995, Social science & medicine.

[49]  K. Bertakis,et al.  A comparison of physician-patient interaction at fee-for-service and HMO sites. , 1993, Family practice research journal.

[50]  E. Emanuel,et al.  Four models of the physician-patient relationship. , 1992, JAMA.

[51]  M. Macy.  Chains of Cooperation: Threshold Effects in Collective Action , 1991 .

[52]  Judith A. Hall,et al.  Studies of doctor-patient interaction. , 1989, Annual review of public health.

[53]  J. Shymansky,et al.  Medical Communication Behavior System: An Interactional Analysis System for Medical Interactions , 1986, Medical care.

[54]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[55]  Mark S. Granovetter.  Economic Action and Social Structure: The Problem of Embeddedness , 1985, American Journal of Sociology.

[56]  Joseph P. Stokes,et al.  Predicting satisfaction with social support from social network structure , 1983 .

[57]  Mark S. Granovetter.  T H E S T R E N G T H O F WEAK TIES: A NETWORK THEORY REVISITED , 1983 .

[58]  W. Kukull,et al.  Outcome-Based Doctor-Patient Interaction Analysis: I. Comparison of Techniques , 1982, Medical care.

[59]  C. Fornell,et al.  Evaluating structural equation models with unobservable variables and measurement error. , 1981 .

[60]  Mark S. Granovetter.  The Strength of Weak Ties , 1973, American Journal of Sociology.

[61]  H. Gans.  The Urban Villagers: Group And Class In The Life Of Italian-Americans , 1963 .