Do the rich grow richer? An empirical analysis of the Matthew effect in an online healthcare community

Abstract

• The Matthew effect aroused by the rating mechanism in the online health community was examined. • Online doctor rating has a significantly positive relationship with doctors’ platform income. • The relationship between online doctor ratings and doctors’ platform income is moderated by the number of thank-you letters and votes that doctors obtained from the online health community, the level of the hospitals with which doctors are affiliated, and the level of the doctors’ clinical and academic titles. Online doctor ratings have become a critical information source for patients’ medical consultation decision support. Although there have been heated discussions about the pros and cons of online doctor ratings, the existing empirical literature remains largely unclear as to whether such ratings would influence the operating mechanism of online health communities. Guided by the Matthew effect, this study investigates whether doctors with higher ratings earn more platform income compared with those with lower ratings. To answer this question, we gathered a seven-month panel dataset comprising data from 5,670 doctors from a large online Chinese healthcare portal. By adopting a panel data model analysis method and multiple robustness checks, we find that online doctor ratings have a significantly positive relationship with doctors’ online income composed of consultation fees and patient remuneration. Moreover, this relationship remains stable when the sorting influence of the ratings is controlled. Furthermore, the effect of online ratings on doctors’ income is stronger for doctors who are affiliated with higher-level hospitals, receive more thank-you letters and votes from patients, and have a higher level of academic and clinical titles. These results demonstrate that platform resources are tilted toward high-quality doctors due to the online rating mechanism in healthcare. Our findings therefore present important theoretical and practical contributions.