Informal Payments and Doctor Engagement in Online Health Community: An Empirical Investigation Using Generalized Synthetic Control
Posted: 3 Nov 2020
Date Written: September 12, 2020
Online health communities are growing rapidly as more individuals seek health information online. Given the importance of doctor engagement, some online health communities have introduced informal payments to doctors to encourage knowledge sharing. In this paper, we empirically examine how informal payments in the form of monetary gifts affect doctor engagement. We leverage the launch of a gifting feature by a leading online health community as a natural experiment that exogenously provides doctors with extra monetary incentives. By adopting multiple strategies to strengthen causal identification, we find that the introduction of informal payments negatively affects doctors’ responses to medical consultations. Our results indicate a crowding-out effect of informal payments on doctors’ intrinsic motivation of contribution. Interestingly, our consultation-level analysis suggests that monetary and non-monetary gifts have distinct roles in motivating doctors’ responses. A non-monetary gift has a more significant carryover effect on follow-up interactions and is more conducive to promoting the doctor-patient relationship. We also find that social status has a moderating effect on the impact of digital gifting on online engagement. Our research has important implications for research and practice. In addition to contributing to the literature on informal payments, our results provide useful implications for online health communities that have implemented or are planning to implement digital gifting to stimulate user engagement.
Keywords: digital gifting, informal payments, healthcare, online community
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