Doctor-patient or patient-patient interaction? Relationships and differences of their roles in influencing patient satisfaction in online health communities

Exploring patients’ satisfaction with online health communities (OHCs) is essential to understanding how OHCs can empower patients. Existing studies primarily investigated the role of external support, while this study explores how doctor-patient (DP) and patient-patient (PP) interactions influence patient satisfaction, with a particular emphasis on intrinsic motivation. Additionally, it investigates the relationships and differences between DP and PP interactions. This study conceptualized patient empowerment as perceived control (PC), perceived support (PS), and shared decision-making (SDM). We developed a model with eight hypotheses to explore these dynamics. The model was tested using structural equation modeling with 470 valid samples, as well as a qualitative post-hoc analysis to provide additional evidence. The empirical results indicate that both DP and PP interactions directly and indirectly influence patient satisfaction, with PC, PS, and SDM acting as mediating factors. DP interaction has a stronger impact on SDM compared to PP interaction, whereas PP interaction has a stronger influence on PC and PS than DP interaction. Our findings reveal that PC, PS, and SDM play a partial mediating role between user interactions and patient satisfaction. DP interaction has a greater influence on patients through SDM, while PP interaction has a greater effect on patients through PC and PS. These insights clarify the distinct roles and impacts of DP and PP interactions on patient satisfaction and offer valuable guidance for the effective operation of OHCs. • We used mixed methods to explore how user interactions affect patient satisfaction. • Patient empowerment mediates user interactions' effect on patient satisfaction. • Doctor-patient interaction exerts greater influence on patients via shared decision-making than patient-patient interaction. • Patient-patient interaction has greater effects on perceived control and perceived support than doctor-patient interaction.