ShanShan Guo
School of Management, Harbin Institute of Technology, P .R. China, 150001 E-mail: hit.guoshanshan@gmail.com;
Xitong Guo
School of Management, Harbin Institute of Technology, P .R. China, 150001 E-mail: xitongguo@gmail.com
Abstract: Noteworthy is that, although the use of eHealth websites has been perceived to be valuable for patients, there is limited research that has focused on the social behavior of doctors who are willing to use eHealth websites. Our research examines how the doctors’ online efforts and offline attributes impacts the benefits brought from eHealth websites to doctors. As social capital investment will bring social capital returns, the target of this paper is identifying which domains of doctors’ social capital investments in eHealth websites, referred to as online efforts and offline attributes domains, lead to which dimension of social capital returns, social returns and economic returns dimensions. Regression results show that the two domains of social capital investments did have significant different effects on the two dimensions of social capital returns. A reasonable explanation about the four types of doctors, defined with differences betweentwo dimensions of social capital returns, will concluded in this study.
1. INTRODUCTION
Nowadays, there are numerous medical demands compared with the dearth of health resourcesto be deal with them, which has become a global problem. In order to solve this problem, information technology has been brought into the health care industry. Research has started to promote the benefits of eHealth websites.
Yang and Tan(Yang & Tan, 2010)claim that an online health community provides various kinds of social support,especially for helping patients to improve their health conditions. In fact, only when doctors and patients, the two stakeholders of eHealth websites, are in a win-win situation, will the developed eHealth websites come to their full potential. Noteworthy is that, although the use of eHealth websites has been perceived to be valuable for patients, there is limited research that has focused on the social behavior of doctors who are willing to use eHealth websites. As we all know, doctors in the healthcare context belong to the donors. For this reason, it is essential to explorehoweHealth websites can add to the benefit of doctors.
Our research examines how the doctors’ online efforts and offline attributes impacts the benefits brought from eHealth websites to doctors. Similar to physical retailers who are willing to open up their online business, such as Barnes & Noble, doctors who are willing to do online consulting are also like running e-commerce on eHealth websites. Though physical retailers and doctors look the same, they are completely different. First, from the perspective of forms of platform, besides e-commerce websites, eHealth websites have the characteristics of social media(Hawe & Shiell, 2000), which contains communication between doctors and patients, patients and patients.In consequence,research abouteHealthwebsites should fusion both in the field of e-commerce and social media；Second, from the perspective of participants, Doctors areindividuals and entities shopsare organizations composed of more than one person. Hence, doctors are different from physical
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shops in behavioral pattern. The doctorsobey individual behavior principles, such as a self-fulfilling intend, etc.
Above all, the motivation of doctors usingeHealthwebsitesis not completely the same to the entities stores e-commerce driven by interests. So we will study the individual doctors’online behavior and offline attributes in eHealth websites.
2. CONCEPTUAL ARGUMENTS
Social behavior motivation theories point out that if people want to benefit from a relationship, they have to invest in it (Lin, 1999). As to the form of investment, apart from the physical and mental form, it also includes attempts at the opportunity of communication (Verbrugge, 1977). Similar to the real world, there is capital in the social network called social capital, which isdefined as resources embedded in a social structure which are accessed and mobilized in purposive action (Comet, 2007; Lin, 1999). The social capital theory pointed out that social relationshipamong people could be productive resources (Coleman, 1988). In this study, we verify the speculation that social capital could be the reason for the motivation of doctors’knowledge sharing through eHealth websites(Yli‐Renko, Autio, & Sapienza, 2001).
Furthermore, Lin (1999)declares that the processes of social capital are investment in social capital, access to and mobilization of social capital and returns of social capital. In addition, the returns following investments in social capital can be classified as economic, political and social returns. Particularly, on the eHealth websites, there are social capital returns of economic and social returns for doctors. However, doctors rarely obtain political returns. In this study，we examine the two dimensions of social capital returns based on doctors’ social capital investment in eHealth websites, which are economic returns and social returns.
The first dimension of social capital returns, economic returns, refers to the range of forms which can bring direct reality economic benefit(Chumbler, Mann, Wu, Schmid, & Kobb, 2004). Here we only consider the direct economic returns for the doctors from eHealth websites, and do not contain the indirect economic returns such as benefit brought by the increase quantity of offline clinic patients. These economic benefits mainly include the doctors' diagnosis and treatment online incomes and telephone therapeutic benefits(Rumberger & Dansky, 2006). That is to say, on eHealthwebsites, the doctor's economic returns are in the form of revenue from websites. The second dimension refers to social returns, which belongs to virtual returns. Social returns vary in aspects such as virtual thanks letter, online votes from patients, and virtual gifts.
These social returns for the doctor from eHealthwebsites is a reflection of a kind of glory. Economic and social returns signify two different dimensions of social capital returns. As Table 1 illustrates, these two dimensions capture four different scenarios of doctors in eHealth websites.
Table 1 Doctors’ Performance Across Social Capital Returns Social Returns
Low High
Economic Returns
Low Doctors who can’t get both enough wealth and glory from eHealth websites
Doctors who prefer glory to wealth brought by eHealth websites eHealth websites which is dynamic investment. The offline attributes entails the originalattributes owned by
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doctors. Though both the domains are important, the nature of the factors is different and revolves around professionals with different efforts. Therefore, the benefits brought by these two factors are also distinct and different between these two domains. In this research, we assess the impact of the online effort and offline attributes of doctors on the two dimensions of doctors’ online social capital returns.
The target of this paper is identifyingwhichdomains of doctors’ social capital investments in eHealth websites lead to which dimension of social capital returns. As mentioned before, the two dimensions of social capital returns capture four different kinds of doctors in eHealth websites. Different kinds of doctors are likely to have different kinds of social capital investment structures. To illustrate, we define Group 1 represents high social returns & high economic returns doctors; Group 2 represents high social returns & low economic returns doctors; Group 3 represents low social returns & low economic returns doctors; Group 4 represents low social returns & high economic returns doctors. This leads us to propose our first two hypotheses:
H1a. For Group 1, both online efforts and offline attributes will be positively associated with social returns.
H1b. For Group 1, only offline efforts will be positively associated with economic returns.
Similarly, for Group 2, we argue that, online efforts are more important for social capital returns gaining.
H2a. For Group 2, only online efforts will be positively associated with social returns.
H2b. For Group 2, only online efforts will be positively associated with economic returns.
For Group 3, the economic and social returns are less. We put forward our third two hypotheses:
H3a. For Group 3,both online efforts and offline attributes will be positively associated with social returns.
H3b. For Group 3,only online efforts will be positively associated with economic returns.
For Group 4, our last two hypotheses are shown below:
H4a. For Group 4,only offline attributes will be positively associated with social returns.
H4b. For Group 4,only offline attributes will be positively associated with economic returns.
4. DATA AND METHODS
For the data, we will use the Good Doctor(www.haodf.com) as our research object. In China，the Good Doctor(www.haodf.com) is the largest eHealthwebsite which includes 3,233 regular hospitals and 303,367 doctors. This study crawled public data of the website through the network spiders on Sep 6, 2013,and the data consisting of numerical information (e.g., fees of telemedicine, the number of papers doctors share, the number of replies to patients, the number of gifts, and recent online time). The observations are all the online doctors belong to coronary heart disease, and the total number of doctors is 1788. To verify the four hypotheses we raised above, quantitative research method, multiple linear regression between groups,will beused.
4.1 Dependent Variables
The dependent variables in this study are social capital returns of doctors. For Good Doctor, the social capital returns are telephone consulting incomes, virtual gifts, thanks letters and votes. K-means cluster was used to make sure which dimension of social capital returns that variables belong to. According to the principle of separabilityand interpretability, final number of clusters is four, which also match our speculation of four kinds of doctors. It was presented in Two-dimensional quadrant method and shown in Figure 2. The front size roughly indicates the amount of observations.
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Figure 1.Two-dimensional quadrant of doctors
4.2 Empirical Model
We estimated the following regression model between four groups of doctors. In addition, imaginary lines indicate the moderating effect between online efforts and offline attributes which have not hypothesized yet.
However, we will consider the moderating effects in when we do further data analysis (There are speculations that Online Efforts significantly impact social returns and Offline Attributes act as moderator, on the contrary,Offline Efforts significantly impact economic returns and Online Attributes act as moderator).
Figure 2. Empirical Model
Social Capital Investments Social Capital Returns
Four types of doctors Online Efforts
Articles Activity Response Period
Social Returns
Thanks letters Virtual gifts Votes
Offline Attributes
Clinic titles Academic titles Hospital degree Hospital location
Economic Returns
Telincomes
Control Variables Gender
Departments Not Yet Hypothesized
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In the expression, g comes from sets G, which contents four types of doctors;i comes from sets I, which contents four independent variables belong to online efforts;j comes from sets J, which contents four independent variables belong to offline attributes.
5. CONCLUSION AND DISCUSSION
Regression results show that the two domains of social capital investments did have significant different effects on the two dimensions of social capital returns. According to the hypotheses, it can be indicated that the effect of the different structuresof social capital investments between different groups of doctors should be different in social capital returns.
The purpose of this paper is to discuss the model of doctor’ssocial capital investment and return on eHealth websites. Furthermore, behavioral suggestions to doctors fully usable of eHealth websites andthe operational suggestions to online eHealth websitesare given. More importantly, this study discover the particular eHealth websites which integratee-commerce sites and social media sites together, which provides a new research target for the network and social capital research.
References
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