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The impact of negative online ratings on physician effort to improve communication: Evidence from China

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  • Li, Zifan
  • Qin, Xuezheng

Abstract

How do negative online ratings affect physician effort? Despite a substantial body of literature on financial incentives, empirical evidence regarding the impact of non-financial incentives on physicians remains limited. This study investigates the influence of negative online ratings on physician effort to improve physician–patient communication, using data from a prominent online healthcare platform. Our findings indicate that negative online ratings lead to a significant increase of 18.7% in the number of online consultations replied to by physicians, a 56.6% rise in the number of words typed, a 43.4% increase in the number of dialogues between physicians and patients, and a 30.1% increase in the number of replies. Additionally, physicians exhibit a more positive tone and greater textual coherence, as evidenced by a 0.37 percentage point increase in the probability of providing high-sentiment replies and a 1.23 percentage point rise in the probability of offering high-similarity responses, indicating a noticeable increase in physician effort to improve communication. The effect is more pronounced among physicians holding senior professional titles and those with higher ratings.

Suggested Citation

  • Li, Zifan & Qin, Xuezheng, 2025. "The impact of negative online ratings on physician effort to improve communication: Evidence from China," China Economic Review, Elsevier, vol. 94(PA).
    • Handle: RePEc:eee:chieco:v:94:y:2025:i:pa:s1043951x2500152x
    DOI: 10.1016/j.chieco.2025.102494
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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity

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