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The success of online health communities (OHCs) depends on maintaining long-term relationships with physicians and preventing churn. Even so, the reasons for physician churn are poorly understood. In this study, an empirical model was proposed from a social influence perspective to explore the effects of online social influence and offline social influence on physician churn, as well as the moderating effect of their online returns.

The empirical data of 4,145 physicians from a Chinese OHC, and probit regression models were employed to verify the proposed theoretical model.

The results suggest that physicians' churn intention is influenced by online and offline social influences, and the offline social influence is more powerful. Physicians' reputational and economic returns could weaken the effect of online social influence on churn intention. However, physicians' economic returns could strengthen the effect of offline social influence on churn intention.

This research study is the first attempt to explore physician churn and divides the social influence into online and offline social influences according to the source of social relationship. The findings contribute to the literature on e-Health, user churn and social influence and provide management implications for OHC managers.

Prescription drug requests and physician denial are important aspects of medical decision making, but little research has been done to identify factors linked to prescription drug request and physician denial. This paper aims to explore factors in relation to patient prescription drug request and provider denial.

The paper is based on a cross‐sectional study in a nationally representative database of 2,988 individuals. Descriptive and multivariate stepwise conditional logistic regression analyses were conducted.

Results of multivariate regression models reveal, after adjusting for personal factors, that heart disease, allergy, anxiety, minor chronic conditions, medical seeking behaviors and direct‐to‐consumer advertising (DTCA) were found to be related to prescription drug request. The denied were individuals with arthritis, less prevalent chronic conditions, the uninsured, and African Americans. It was also found that 27.4 percent of the sample requested a prescription drug and about 24 percent of those who segmented for prescriptions were physicians.

DTCA is positively associated with prescription drug requests but the analysis did not support any effect of DTCA on the refusal status. Patients' requests and physician decision making to refuse are somewhat complicated and vary with different medical conditions.

The paper, using nationally representative data, investigates the factors associated with prescription drug request and denial.

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals consumers are taking an active role in their own health management. Chronic illnesses such as diabetes and asthma require a significant amount of self‐management and thus call for a collaborative patient‐physician relationship. This study explores whether empowering patient‐physician consultations measured through three patient empowerment dimensions (patient control, patient participation, physician support) enhance patients trust in and commitment to their physician.

A comprehensive mail survey of adults registered with one of four different chronic illness associations in Australia was conducted to collect the data.

The structural equation modelling results show that patients are more trusting of and committed to physicians who adopt an empowering communication style with them.

This study focuses on the Australian healthcare context. Thus, future multinational studies should explore suitable strategies to empower healthcare consumers that build on the constraints placed by diverse healthcare systems.

In a managed health care and cost cutting climate where patient trust is deteriorating, these findings suggest that empowering patients presents a means to improve the patient‐physician relationship.

Whilst numerous marketing scholars have researched the empowerment of staff, there is a shortage of studies that address the meaning and outcomes of consumer empowerment. This study proposes a unique communication based consumer empowerment construct which is shown to impact on consumer‐service provider relationships.

The online distribution of prescription‐only pharmaceutical products raises serious legal and regulatory issues, including how governments, agencies, or organizations will regulate and monitor such activities, particularly when the distributors are offshore Web sites. This paper discusses the current regulatory environment for marketing prescription‐only drugs online and distributing them across national borders, along with product liability issues. Four hypothetical scenarios focus on key legal and regulatory issues.

This paper aims to study the post-patent ethical drug market and simulate the impact of Patient Protection and Affordable Care Act (ACA) on individuals, health-care providers and pharmaceutical firms. US policymakers have been looking at various ways to curb rising health-care costs in USA, including ways to promote the use of generic drugs in lieu of brand drugs. In this broader context, the implementation of ACA in December 2013 will introduce major changes in the pharmaceutical market.

To fully understand the impact of such policy changes, we develop a structural model to study consumers’ buying behavior and firm competition in the post-patent ethical drug markets. We use the estimated model parameters to conduct four policy simulations to illustrate the effect of Obamacare on increasing the relative size of price-insensitive segment, reducing price sensitivity in the price-sensitive segment, providing brand price discount to Medicare patients previously in the “donut hole” and the effect of change in people’s attitude toward generics.

Our model estimation reveals two classes of consumers with different price sensitivities. This heterogeneity explains the increase in the brand price after generic entry. We identify consumers’ switching costs between generic and brand drugs, as well as among different generics. From the policy simulation, we find that except the closure of Medicare donut hole, all other policy changes lead to increased usage of the focal molecule, and the efforts to increase insurance coverage and reduce the out of pocket payment for prescription drugs lead to increase in firm profit.

This paper is the first to illustrate the potential policy effect of Obamacare through a structural model on post-patent ethical drug market.

The rapid proliferation of drugs being switched from prescription (Rx) to over‐the‐counter (OTC) status within the USA has raised a number of important consumer behavior and public policy concerns. The following issue served as the focus of our research. Given the increasing assortment and widespread availability of Rx to OTC switch drugs, how might consumers’ health care preferences change? That is, what factors influence whether a consumer is more likely to visit their physician rather than self‐medicate symptoms of heartburn and indigestion with a new switch drug?

Pharmaceutical companies' marketing strategies have traditionally targeted only physicians and, more recently, consumers. The purpose of this paper is to explore the role of the pharmacist as prescriber, influencer, switcher, and dispenser of pharmaceutical drugs in one developing country, Egypt.

The authors surveyed pharmacists in Cairo, Egypt. The pharmacists were asked to estimate the percentages of patients who came in with a prescription, with only a box or a recommendation for a medicine and with only symptoms, and whether he/she switched the patient to another medicine. Pharmacies were classified as to the social class of the pharmacy neighborhoods. Cluster analysis was used to further classify pharmacists as “Influencers” and “Non‐influencers”.

Overall the pharmacists influence 39 percent of all purchase decisions for pharmaceuticals with higher levels of influence in lower social class neighborhoods. Approximately one out of four pharmacists was classified as an Influencer.

In developing countries, the pharmacist plays a key role in which medicines patients ultimately purchase. Marketing activities directed toward the pharmacist may provide an important opportunity to maximize the pharmaceutical firms' return on marketing investment.

Few studies have looked at the marketing of pharmaceutical drugs in developing countries. This paper is unique in that it examines the role of the pharmacist in these markets, thus providing an important addition to the understanding of the challenges to the industry in these countries and important implications for pharmaceutical marketing strategies.

France is a country that widely relies on a skilled labour force. Nevertheless, very little is written in the management literature on the career experiences of skilled migrants, in particular from developing countries, in France. This paper argues that in order to understand the management of skilled migrants in France, there is a need to better understand their career experiences. Therefore, the objective of this paper is to fill this knowledge gap by offering an enhanced understanding of the career experiences of Malagasy migrant physicians in France.

Based on the life story of 17 Malagasy migrant physicians and an interview with a Malagasy director of a private clinic who recruited Malagasy physicians to work in France, the paper sheds light on their career choices and challenges that they face in the French job market.

The results clearly highlight two career profiles: firstly, those who succeeded in working as physicians either directly upon their graduation, or throughout an “interstitial” career in nursing, a way to eventually reach their profession of physician. Second, findings show that there were participants who definitively switched to a nursing profession. For this second group, migration emerges as a challenging experience leading to talent waste and therefore to downward career mobility.

While literature on international careers frequently describe international mobility as being beneficial for skilled migrants, the findings yield limited support for this assumption. Instead, human capital was insufficient in explaining the career outcome of migrant physicians in France. Beyond the assumption that human capital is sufficient for undertaking a successful international experience, the paper contribute's to the literature on international careers by focusing on an under‐researched group (i.e. Malagasy physicians in France) and demonstrating the complex nature of their career experiences.

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently.

A conceptual model including behavioural dimensions of patient‐physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in‐patients.

Hospital C has above‐average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under‐average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health‐care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy.

The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health‐care quality strategies.

In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change‐oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

During the 1980s, hospital merger activity was growing steadily due to fundamental changes in the provision of health care. Recently, however, the US Government has escalated its anti‐trust scrutiny of hospital mergers. Provides an indepth analysis of two recent hospital mergers, one of which was successful and the other was not. Any hospital considering a merger can benefit from analysing the strategies that were used to combat the anti‐trust challenge in both cases.