The Impact of Monetary Incentives on Physician Prosocial Behavior in Online Medical Consulting Platforms: Evidence From China

BACKGROUND: In online medical consulting platforms, physicians can get both economic and social returns by offering online medical services, such as answering questions or sharing health care knowledge with patients. Physicians’ online prosocial behavior could bring many benefits to the health care industry. Monetary incentives could encourage physicians to engage more in online medical communities. However, little research has studied the impact of monetary incentives on physician prosocial behavior and the heterogeneity of this effect. OBJECTIVE: This study aims to explore the effects of monetary incentives on physician prosocial behavior and investigate the moderation effects of self-recognition and recognition from others of physician competence. METHODS: This study was a fixed-effect specification-regression model based on a difference-in-differences design with robust standard errors clustered at the physician level using monthly panel data. It included 26,543 physicians in 3851 hospitals over 133 months (November 2006-December 2017) from a leading online health care platform in China. We used the pricing strategy of physicians and satisfaction levels to measure their own and patients’ degree of recognition, respectively. Physicians’ prosocial behavior was measured by free services offered. RESULTS: The introduction of monetary incentives had a positive effect on physician prosocial behavior (β=1.057, P<.01). Higher self-recognition and others’ recognition level of physician competence increased this promotion effect (γ=0.275, P<.01 and γ=0.325, P<.01). CONCLUSIONS: This study explored the positive effect of the introduction of monetary incentives on physician prosocial behavior. We found this effect was enhanced for physicians with a high level of self-recognition and others’ recognition of their competence. We provide evidence of the effect of monetary incentives on physicians’ prosocial behaviors in the telemedicine markets and insight for relevant stakeholders into how to design an effective incentive mechanism to improve physicians’ prosocial engagements.