5월 4주차

Digital platforms are reshaping professional service delivery, yet how online engagement feeds back into offline clinical practice remains unclear. This study examines whether physicians’ information provision on healthcare question-and-answer platforms influences treatment decisions in hospital care. Drawing on cognitive consistency and professional identity theories, the study proposes a mechanism of identity-based digital commitment whereby publicly articulated medical advice functions as a “cognitive anchor,” creating pressure for physicians to align subsequent bedside decisions with the online standards, particularly in discretionary domains that are vulnerable to economic or institutional pressures. Using a physician-level matched data set that links a leading online health platform to hospital electronic health records, the analysis shows that physicians with higher levels of online advisory activity are associated with reduced overall medication costs, lower uncovered medication cost ratios, and lengths of stay that more closely adhere to guideline benchmarks. Mediation and stratified analyses mitigate concerns that these patterns are driven by patient selection or improved patient adherence alone, whereas moderation by dimensions of professional commitment and content relevance provides supportive evidence for a cognitive consistency mechanism. The results are robust to alternative model specifications and controls for peer spillovers, digital reputation, and local market conditions, indicating no deterioration in clinical quality as readmission and mortality rates remain unchanged. Overall, the findings position digital platforms as a form of “soft governance” that complements formal oversight by activating intrinsic professional motives for consistency between online identity and offline practice. History: Rajiv Kohli, Senior Editor; Wenjing Duan, Associate Editor. Funding: This work was supported by the Key Program of National Natural Science Foundation of China [Grant 72231009], the General Program of National Natural Science Foundation of China [Grant 72472128], the Science Fund for Creative Research Groups of the National Natural Science Foundation of China [Grant 71821002], the National University of Singapore, the Provost’s Chair Grant [Grant E-253-00-0021-01], and the Fundamental Research Funds for the Central Universities [Grant D5000240057]. Supplemental Material: The online appendices are available at https://doi.org/10.1287/isre.2022.0136 .

As digital platforms increasingly rely on automated tools to govern user expression, an important practical question is whether algorithmic moderation can improve content quality without undermining user cooperation. Drawing on Wikipedia’s bot-based enforcement of neutrality rules, we find an unintended consequence: Contributors whose prior edits are moderated often respond with more politically slanted subsequent expression, rather than moving closer to neutrality. This pattern is stronger when moderation targets a contributor’s focal area of attention, among contributors with stronger prior political bias, and after repeated bot intervention. It is weaker when moderation occurs outside the contributor’s focal area and among contributors with greater experience in politically sensitive topics. Together, these findings suggest that effective platform governance requires more than scalable automated enforcement. For platform leaders, the results underscore the value of pairing bots with transparent explanations, context-sensitive messaging, and human oversight. For policymakers, the study indicates that algorithmic content governance should be evaluated not only by its ability to remove problematic content, but also by its downstream effects on user behavior, participation, and polarization. Well-designed governance systems must balance rule enforcement with users’ sense of autonomy.

The information technology (IT) industry is especially vulnerable to patent trolls because digital products combine modular, interdependent, and software-intensive components, making patent claims difficult to isolate and easy to assert broadly. Many U.S. states responded by adopting patent troll laws aimed at abusive demand letters. These laws can affect firms through two channels; they may reduce litigation risk by discouraging coercive threats, but they may also increase compliance costs by requiring greater disclosure when asserting patents. We leverage staggered adoption across U.S. states and track 900 IT firms from 2012 to 2019. We find that these laws are associated with higher overall patenting, but the increase is concentrated in areas where firms already have experience; patenting in new areas does not increase on average. Consistent with the two-channel mechanism, firms with greater prior exposure to troll litigation show larger increases in patenting in familiar areas, whereas firms facing higher expected compliance burdens show lower patenting in new areas. These differences are more pronounced in laws with more stringent disclosure and enforcement provisions, highlighting the tension between deterrence and compliance costs. For policymakers, the findings show how to design these laws: deter abusive assertions without imposing compliance burdens that dampen longer-term technological search.