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The success of online health communities (OHCs) depends on maintaining long-term relationships with physicians and preventing churn. Even so, the reasons for physician churn are poorly understood. In this study, an empirical model was proposed from a social influence perspective to explore the effects of online social influence and offline social influence on physician churn, as well as the moderating effect of their online returns.

The empirical data of 4,145 physicians from a Chinese OHC, and probit regression models were employed to verify the proposed theoretical model.

The results suggest that physicians' churn intention is influenced by online and offline social influences, and the offline social influence is more powerful. Physicians' reputational and economic returns could weaken the effect of online social influence on churn intention. However, physicians' economic returns could strengthen the effect of offline social influence on churn intention.

This research study is the first attempt to explore physician churn and divides the social influence into online and offline social influences according to the source of social relationship. The findings contribute to the literature on e-Health, user churn and social influence and provide management implications for OHC managers.

Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.

Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.

The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.

This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.