Economic Success of Physicians in the Online Consultation Market: A Signaling Theory Perspective

Jia Li, Jie Tang, Ling Jiang, David C. Yen, and Xuan Liu
International Journal of Electronic Commerce,
Volume 23, Number 2, 2019, pp. 244-271.


E-consultation is considerably significant in today’s highly competitive environment in reducing medical costs, improving operational efficiency and effectiveness, enhancing the equity of medical resources, and meeting customers’ satisfaction. However, the prosperity of e-consultation depends on doctors’ consistent participation and continued contribution. In addition, receiving a monetary return may be deemed as one of the major factors for doctors to stay on e-consultation platforms and provide the needed online services. This study investigates how a physician can achieve economic success in the online consultation market from the perspective of signaling theory. A secondary data econometric analysis using transaction data obtained from an e-consultation Website ( was conducted. The obtained results indicate that both seller signals (knowledge contribution) and market signals (reputation), which are observable from the Website, may positively affect physicians’ income. In fact, the two types of online signals are the substitutes for each other; in addition, the impacts of both seller signals (knowledge contribution) and market signals (reputation) obtained from the Website were negatively moderated (weakened) by the offline signals (status). This study contributes to the literature by making a clear distinction between the online and offline signals, as well as between the seller signals and market signals. This study also provides practical implications, indicating that knowledge contribution and reputation are two important factors for physicians to increase their online income.

Key Words and Phrases: E-healthcare, electronic consultation, knowledge contribution, medical consultation, reputation, physician income, signaling theory, status.