Not just in, but how: Leading physicians’ engagement strategies and patients’ continuous use of online medical team services

Abstract

Drawing on the signaling theory, this study investigates how the leading physicians’ two distinct engagement strategies, direct and indirect engagement, influence patients’ continuous use of online medical team (OMT) service. This study employs a mixed-methods design, using a qualitative study to support the development of hypotheses and identify additional signals that may serve as potential moderators while utilizing a quantitative approach to provide empirical examination. The findings reveal that leading physicians’ direct engagement positively predicts continuous use, while their indirect engagement is negatively associated with continuous use. The signal of OMT’s historical performance strengthens the effect of direct engagement on patient continuous use, yet it does not significantly moderate the relationship between indirect engagement and continuous use. The signal of OMT’s current performance has no significant moderating effect on either engagement strategy. The post hoc analysis shows that the leading physicians’ individual performance signal positively moderates the relationships between both direct and indirect engagement and patient continuous use. This study elucidates how leading physicians’ distinct engagement strategies serve as differential signaling mechanisms, resulting in divergent outcomes for patient continuous use. Furthermore, it highlights the interplay between these strategy-induced signals and other contextual cues within the OMT environment, collectively shaping patients’ decision-making.