Online dialogue with medical professionals: An empirical study of an online "Ask the Doctor" platform

Background: Accessing medical resources has been a challenging issue in China, particularly for people who do not live in big cities. Online "Ask the doctor" (AtD) services are gaining popularity rapidly. On AtDs, patients or their caregivers can ask questions to medical professionals and receive medical advice without going through the hassles of visiting local hospitals or doctors' offices. However, the communication patterns and remaining challenges of this tool are understudied.Objective: The purpose of this study was to (1) explore the dialogue patterns between the patients and the doctors on an AtD service in China, (2) identify issues and remaining challenges in this new form of communication. Methods: We conducted an exploratory study to analyze the dialogues between patients and doctors as well as patients' reviews. To analyze the dialogue data, we took inspiration from the discourse analysis and focus on the various components of the dialogues. We also used thematic analysis to discover the underlying themes embedded in each dialogue, and identify themes from patient complaints.Results: We identified four stages in the dialogues between the patients and doctors, including the initiating stage, continuing stage, ending stage, and following up stage. We also summarized the common patterns in the first three stages and reasons for sending follow-up messages. Moreover, we identified 6 unique challenges of the AtD service, including (1) inefficient communication in the initial stage, (2) unfinished conversation in the ending stage, (3) communication is perceived as real-time by the patients, not by the doctors, (4) drawbacks of voice messages, (5) verge of the illegal behaviors, and (6) consultation is not worth the payment.Conclusions: The AtD service provides the follow-up communication pattern which is considered as a good supplement of Chinese traditional health care. However, several barriers, such as ethical problems, mismatched perceptions and expectations, cost-effectiveness issue still need further investigation.