What motivates doctors' knowledge contribution in online healthcare consultation? Insights from doctor–patient interaction

Purpose Doctors' knowledge contribution (DKC) in online healthcare consultation is crucial for addressing patients' information needs and ensuring service quality. While existing studies often adopt a doctor-oriented perspective, limited attention has been paid to how DKC varies across different doctor–patient interaction contexts. This study aims to address this gap by examining the factors influencing DKC from a doctor–patient interaction perspective. Design/methodology/approach Based on signaling theory and self-determination theory, this study develops a theoretical model examining how patients' communication behaviors, including instrumental communication intensity (ICI), negative emotional expression (NEE) and response time (RT), serve as interactional signals shaping DKC, and how external rewards, including monetary rewards (MR) and psychological rewards (PR), moderate doctors' responses to these signals. This model is empirically tested using a dataset from a leading Chinese online healthcare consultation platform. Findings Patients' ICI and NEE positively influence DKC, while RT has a negative effect. Both MR and PR strengthen the positive impact of ICI, and PR weakens the negative impact of RT. However, neither reward moderates the relationship between NEE and DKC. Furthermore, these effects exhibit heterogeneity across doctors with different attributes and across medical contexts. Originality/value By investigating the role of patients' communication behaviors and their interaction with external rewards in shaping DKC during online doctor–patient interactions, this study advances the literature on knowledge contribution, doctor–patient interactions and the interplay between external rewards and patient-generated signals in online healthcare. It also provides practical guidance for managing online healthcare platforms and enhancing service quality.