In recent years, many online healthcare communities (OHCs) in China introduced the feature of free live- streamed medical consultations (FLSMC), which allows patients to communicate with physicians and have an interactive consultation for free through live streaming. Despite the rapid growth of FLSMC, little is known about whether FLSMC can bring benefits to patients when they have online consultation needs in the future. Drawing on signaling theory, this study examines the impact of FLSMC on patient engagement and patient satisfaction in the multistage online consultation process. We further explore the moderating effects of physician's owned and earned signals in the pre-consultation stage by integrating social capital theory with signaling theory. We collect a panel data set of 16,151 physicians from a leading OHC in China. Based on the DID method, a quasi- experimental design, and the instrumental variable method, we demonstrate that FLSMC has a positive effect on patient choice, patient messaging, and patient satisfaction. In addition, we find that the physician's title and online rating can positively moderate the effects of FLSMC on patient choice. This study not only sheds light on the literature on online healthcare by identifying the role of signals in the context of FLSMC, but also provides decision support for patients, physicians, and OHC managers.
