How Doctors Gain Social and Economic Returns in Online Health-Care Communities: A Professional Capital Perspective

Abstract

An online health-care community (OHC) is a novel channel through which doctors share medical or health-care knowledge with patients. While the sustainable development of an OHC relies on doctors’ participation, we have limited information on how doctors can gain benefits from OHCs. In attempting to close this knowledge gap, we examine the determinants of social and economic returns of doctors at OHCs by extending the social exchange theory into the professional domain. The notion of professional capital, as a set of renewable resources for social professionals developed by good education within a territory of social practice, is introduced to understand the unique resources available to doctors for social exchange. Specifically, we examine the effects of status capital and decisional capital (two dimensions of professional capital) on doctors’ social and economic returns. Moreover, we explore how such effects differ across different doctor groups. The results show that, in addition to the widespread pursuit of celebrity doctors (who can be recognized by their high status capital) offline, the doctor’s decisional capital is also an important professional component in maintaining exchange returns at OHCs. This study provides empirical evidence of the relationship between professional capital and the exchange returns, and extends prior research on OHCs through a professional capital perspective with implications for theory and practice.

Key words and phrases:

• online communities
• online health-care community
• professional capital
• social exchange theory

Supplemental File

Supplemental data for this article can be found on the publisher’s website at 10.1080/07421222.2017.1334480

Funding

This study was partially funded by the National Natural Science Foundation of China [Grants 71531007, 71622002, 71471048, 71471049, and 71490720].

Notes

1. Besides social and economic returns (which are regarded as extrinsic returns that are rewarded extrinsically) [43], intrinsic returns, which realize the natural human propensities such as enjoyment and altruism, may also exist [39, 62, 71]. Intrinsic returns are drawn from individual feelings that are independent of externals (e.g., patients and OHCs). Considering this point, our study examines the two-way social exchange between doctors and patients and underlines the important role of OHCs in providing doctors’ extrinsic returns (social and exchange returns), as we believe extrinsic returns are more salient in this OHC context. Indeed, a statistic in our focal OHC shows that all the active doctors (29,337) have received extrinsic returns.

2. The structural, occupational, and institutional arrangements need to provide exclusive training and education, to test the competence of professionals internally, and provide some professional organization.

3. Similarly, the quality of the individual as well as the interpersonal relationships that are the foundations of human capital and social capital are explicitly defined as parts of professional capital by Hargreaves [29].

4. British Dictionary definitions for commitment include: “(3) an obligation, promise, etc. that restricts one’s freedom of action.” In this study, it is the doctor’s commitment to his/her social profession.

5. Because there is not a concept of a personal or family doctor prevalent in China, as more mergers are taking place, and hospital groups are becoming larger with more centrally driven reimbursement around the world.

6. China has a strict and uniform assessment standard for doctors’ clinical titles, which is related to the doctor’s personal ability (unrelated to their hospital level), for example, in terms of work experience, education, and unified exams, and so on.

7. As “pure professionalism” has its own associational, educational, and occupational structure, most doctors, in addition to serving in a hospital, also teach in medical schools to guarantee the sustainable development of the industry.

8. This phenomenon originates from the promotion policies of the target OHC, such as registration bonus and other short-term incentives for a trial.

Additional information

Funding

This study was partially funded by the National Natural Science Foundation of China [Grants 71531007, 71622002, 71471048, 71471049, and 71490720].

Notes on contributors

Shanshan Guo

Shanshan Guo ([email protected]) is a Ph.D. candidate in management science and engineering at the School of Management, Harbin Institute of Technology, China. She is in a joint doctoral program with the National University of Singapore. Her research interests include e-health, online health-care community, health-care capital, and social media.

Xitong Guo ([email protected]; corresponding author) is a professor of information systems at the Harbin Institute of Technology. He received his Ph.D. in information systems at the City University of Hong Kong and a Ph.D. in management science and engineering at the University of Science and Technology of China. His research focuses on e-health. He has published in Journal of Management Information Systems, Journal of the Association for Information Systems, and ACM Transactions on Management Information Systems, among others.

Xitong Guo

Shanshan Guo ([email protected]) is a Ph.D. candidate in management science and engineering at the School of Management, Harbin Institute of Technology, China. She is in a joint doctoral program with the National University of Singapore. Her research interests include e-health, online health-care community, health-care capital, and social media.

Xitong Guo ([email protected]; corresponding author) is a professor of information systems at the Harbin Institute of Technology. He received his Ph.D. in information systems at the City University of Hong Kong and a Ph.D. in management science and engineering at the University of Science and Technology of China. His research focuses on e-health. He has published in Journal of Management Information Systems, Journal of the Association for Information Systems, and ACM Transactions on Management Information Systems, among others.

Yulin Fang

Yulin Fang ([email protected]) is an associate professor in the Department of Information Systems, City University of Hong Kong. He obtained his Ph.D. at the Richard Ivey School of Business, Western University. His research is focused on knowledge management and innovation, social media, and e-commerce. He has published in Information Systems Research, Journal of Management Information Systems, MIS Quarterly, Strategic Management Journal, and Organizational Research Methods, among others. He has served as associate editor for MIS Quarterly and senior editor for Information Systems Research.

Doug Vogel

Doug Vogel ([email protected]) is a professor of information systems (IS) and director of the eHealth Research Institute of the Harbin Institute of Technology School of Management in China. He received his Ph.D. in business administration (management information systems) from the University of Minnesota. He has published widely and has been recognized as the most-cited IS author in the Asia-Pacific. He is engaged in introducing mobile devices and support for integrated collaborative applications in educational and health-care systems with a focus on well-being.