Living Up to Online Advice: How Health Platforms Influence Physicians’ Offline Practice

Digital platforms are reshaping professional service delivery, yet how online engagement feeds back into offline clinical practice remains unclear. This study examines whether physicians’ information provision on healthcare question-and-answer platforms influences treatment decisions in hospital care. Drawing on cognitive consistency and professional identity theories, the study proposes a mechanism of identity-based digital commitment whereby publicly articulated medical advice functions as a “cognitive anchor,” creating pressure for physicians to align subsequent bedside decisions with the online standards, particularly in discretionary domains that are vulnerable to economic or institutional pressures. Using a physician-level matched data set that links a leading online health platform to hospital electronic health records, the analysis shows that physicians with higher levels of online advisory activity are associated with reduced overall medication costs, lower uncovered medication cost ratios, and lengths of stay that more closely adhere to guideline benchmarks. Mediation and stratified analyses mitigate concerns that these patterns are driven by patient selection or improved patient adherence alone, whereas moderation by dimensions of professional commitment and content relevance provides supportive evidence for a cognitive consistency mechanism. The results are robust to alternative model specifications and controls for peer spillovers, digital reputation, and local market conditions, indicating no deterioration in clinical quality as readmission and mortality rates remain unchanged. Overall, the findings position digital platforms as a form of “soft governance” that complements formal oversight by activating intrinsic professional motives for consistency between online identity and offline practice.

History: Rajiv Kohli, Senior Editor; Wenjing Duan, Associate Editor.

Funding: This work was supported by the Key Program of National Natural Science Foundation of China [Grant 72231009], the General Program of National Natural Science Foundation of China [Grant 72472128], the Science Fund for Creative Research Groups of the National Natural Science Foundation of China [Grant 71821002], the National University of Singapore, the Provost’s Chair Grant [Grant E-253-00-0021-01], and the Fundamental Research Funds for the Central Universities [Grant D5000240057].

Supplemental Material: The online appendices are available at https://doi.org/10.1287/isre.2022.0136.